I read with great interest the recent publication by Nantakomol and colleagues, Affordable Technology for Enumeration of the Absolute CD4 T-Lymphocyte Count by Cell Bead Assay. 1 The title and content of this publication appear very similar to a previously published article by many of these same authors. 2 Moreover, if the principal difference between these two publications is the emphasis on the issue of "affordability" in the LabMedicine publication, then this publication should have included a cost comparison between traditional methods for counting CD4+ lymphocytes vs the method discussed by the authors across different laboratory settings and a discussion of the internal and external quality control procedures, including cost, related to this putative "affordable" method.We appreciate Dr. Wiwanitkit's interest in our publication. The principal differences between our current publication in LabMedicine and our previous publication in Cytometry Part B are the discussion in the LabMedicine publication of affordability, a modification of the cell bead-based (CB) assay, and a summary of the overall analytical and clinical performance characteristics of the cell CB assay as an alternative to a latex bead-based (LB) assay or a flow rate-based calibration (FR) method for CD4+ T-lymphocyte counts. Another difference is the focus in the Cytometry Part B publication on the diagnostic performance of the CB assay using blood samples selected from a population of HIV+ individuals. 1,2 Cost data, relevant to the CB-assay compared to LB and FR methods, are shown clearly in Table 2 of the LabMedicine publication. 1 The total cost of the CB assay is approximately half that of the CB and FR assays, while the analytical and clinical performance characteristics of the CB assay are comparable to those of the CB and FR assays. Therefore, in countries with limited financial resources and a large population of HIV-infected individuals, the CB assay represents an attractive alternative to LB and FR methods for quantifying CD4+ T-lymphocytes.