The Basics
Written by the doctors and editors at UpToDate � �
How do doctors monitor people with HIV? " � Doctors monitor people with HIV by doing regular exams and talking to them, and by doing tests. Among the tests doctors use, 2 are especially important in keeping track of whether HIV treatment is working. These are called the "viral load test " � and the "CD4 cell count. " � � �
What is viral load? " � Viral load is the amount of virus in your blood. If you have HIV, its important to have your viral load tested often. This test helps your doctors check on your infection. It can also show whether your treatment is working. � �
The goal of treatment is to get your viral load below "detectable levels. " � That means there is so little virus in your blood that the test cannot even pick it up. � �
What are CD4 cell counts? " � HIV attacks and destroys the cells in your body that fight infection. This virus especially likes to kill a type of cell called "CD4+ T " � cells " � often called "CD4 cells " � or "T cells " � for short. � �
The number of CD4 cells you have has a lot to do with how well you fight infection. In general, people who have CD4 cell counts below 200 have a hard time fighting infections. They can get something called "opportunistic " � infections. Opportunistic infections are caused by germs that healthy people can usually fight off. In people with HIV, though, these germs can cause infection. � �
If your CD4 count gets too low, your doctor will probably want to give you medicines to keep you from getting opportunistic infections. For example, if your CD4 count falls below 200, your doctor might give you antibiotics to prevent a lung infection called "PCP pneumonia. " � When your CD4 counts get back up over 200, you can stop the antibiotics. � �
How often should I have viral load and CD4 tests? " � How often you should be tested will depend on how your treatment is going and how recently you were diagnosed with HIV. � �
Some people need to be tested every 2 to 8 weeks. This might include people who: � �
- Were recently diagnosed
- Recently started treatment
- Recently changed treatment
It is very important that you follow your doctor's instructions about getting tested. The results of your viral load tests will tell your doctor whether your HIV treatment is helping. The results of your CD4 tests will tell your doctor how well your immune system is working. � �
People whose HIV seems to be under control and who are not changing medicines or doses might go 6 months to a year between testing. � �
Can anything besides HIV affect viral load and CD4 test results? " � Your viral load is mostly affected by your HIV treatment. If your treatment is working right, your viral load should go down below the level that test can even detect. � �
CD4 counts can go down because of a lot of things, including: � �
- Infections (other than HIV)
- Alcohol abuse
- Pregnancy
- Liver disease
All topics are updated as new evidence becomes available and our peer review process is complete. � �
This topic retrieved from UpToDate on: Nov 04, 2014. � �
Topic 16937 Version 3.0 � �
Release: 22.8 - C22.208 � �
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� � 2014 UpToDate, Inc. All rights reserved. � �