CD4 and hemophagocytic syndrome: As mentioned in Table 2,the diagnosis of HLH is made when 5 out of the 8 criteria are met; however, inHIV-infected individuals, hemophagocytosis may not be readily evident and repeattesting may be necessary.3,8Treatment should be started promptly considering that HIV-associated HLH can be morefulminant and aggressive with higher mortality rates in those with CD4 counts lessthan 200 cells/μL.3,4