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Lymphocyte subsets (TBNK)

Service
Test Background

This test uses flow cytometry to count absolute numbers and proportions of peripheral blood T-cells (CD3, CD4, and CD8), B-cells (CD19) and NK cells (CD56/CD16) within the lymphocyte population.

Untreated HIV positive patients usually have reduced CD4 T cells or a reduced CD4/CD8 cell ratio, often in conjunction with an absolute lymphocytopaenia. Whilst a low CD4+ T cell count is no longer a criteria for starting ART (anti-retroviral therapy) in HIV positive patients, regular monitoring of CD4+ T cell counts remains an important tool for the assessment of immune reconstitution in patients with a late diagnosis and as a guide for the requirement of antimicrobial prophylaxis to prevent opportunistic infections. Regular monitoring of CD4 T cell counts is recommended in patients who choose not to start ART and in those who have just commenced or changed ART.

Measurement of TBNK subsets are included in the diagnostic criteria for SCID (severe combined immune deficiency), XLA (X-linked agammaglobulinaemia), 22q11.2 syndrome, and Goods syndrome (thymoma with immune deficiency).

Lymphocyte subsets are further used in the assessment of immune reconstitution post-transplant or post B cell depleting therapy (e.g. Rituximab).

Clinical Indications

Monitoring of HIV infection
Investigation of primary and secondary immune deficiency
Monitoring of immune reconstitution

Reference Range
Adult ranges (>18 years) 
CD3+ T lymphocytes 55-83
CD3+ T lymphocytes Absolute 700-2100
CD3+/CD4+ T lymphocyte % 28-57
CD3+/CD4+ T lymphocyte Absolute 300-1400
CD3+/CD8+ T lymphocyte % 10-39
CD3+/CD8+ T lymphocyte Absolute 200-900
CD19+ B lymphocyte % 6-19
CD19+ B lymphocyte Absolute 100-500
CD3-/CD16-CD56+ NK cells % 7-31
CD3-/CD16-CD56+ NK cells Absolute 90-600
Absolute Lymphocytes 1000-2800

NB values for children vary according to age

Reference ranges from Comans-Bitter WM,et al. Immunophenotyping of blood lymphocytes in childhood. Reference values for lymphocyte subpopulations. J Pediatr. 1997 Mar;130(3):388-93.

Sample volume
3 mL EDTA
Turnaround time
3 days
Sample & Container Required
EDTA (lavender top); Do not separate or refrigerate
Accreditation

This test is not currently accredited

Record last updated
December 15, 2025

Sample Container

4ml EDTA Vacutainers (Lavender top)

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Test Results

Yes, we have a Pathology User Guide

Yes. Please email your request to Imperial.nwlpcustomerservice@nhs.net

Results are communicated to clinical staff and are normally not communicated direct to patients either on telephone requests or in written report. If you need to contact us please click here to view the contact details page

Please contact the Customer Service Team Monday to Friday from 8:30am – 6:00pm on 0203 313 5353. Alternatively, see the Pathology User Guide for how to contact the relevant department. If advice is not urgent you can also email your query to Imperial.nwlpcustomerservice@nhs.net

Additional tests may be added by discussion with the relevant laboratory. The time limit for adding additional tests to a sample already received in the laboratory will depend on the type of sample and the department it was sent to.

Information on the repertoire of tests performed by pathology, including reference ranges, turnaround times and specimen requirements, can be found in the test directory.

NWLP operates UKAS accredited medical laboratories as per the references below. The current scope of accreditation for all NWLP’s laboratories can be found on the UKAS website.

See the following UKAS ref numbers:

  • Clinical Biochemistry Ref: 8673
  • Haematology and Blood Transfusion Ref: 8674
  • Infection & Immunity Sciences (Including Immunology, Virology, Microbiology and Histocompatibility and Immunogenetics ) Ref: 8659
  • Cellular Pathology (Including Histopathology, Cytology and Molecular Pathology) Ref: 9615

If you require copies of our certificate of accreditation and associated documentation please contact Imperial.nwlpcustomerservice@nhs.net.

UKAS requires the laboratories to be accredited for a particular repertoire/scope (ISO15189), any changes or additions to repertoire require assessment by UKAS (extension to scope).

The BD Hospital Tube GuideBD GP Tube Guide and BD Paediatric Tube Guide provide visual references to the correct tube types and collection instructions.

Home testing

INSTRUCTION SHEET FOR BLOOD SAMPLE COLLECTION 

We also have two instruction videos available (one with subtitles and one without) – please click on the links to view the videos on Google.

VIDEO ON BLOOD SAMPLE COLLECTION (without subtitles)

VIDEO ON BLOOD SAMPLE COLLECTION (with subtitles)

Our accreditations

Upholding excellence in diagnostic standards

Our laboratories are accredited by the UK Accreditation Service (UKAS) against the international standard ISO15189:2022. UKAS is the accreditation body for the UK that assesses medical laboratories.

Find out more about our accreditations on the UKAS website.

UKAS website
Man in the lab handling a sample