Tests to Monitor HIV

The Basics

Written by the doctors and editors at UpToDate пїЅ пїЅ

How do doctors monitor people with HIV? " пїЅ 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 " пїЅ and the "CD4 cell count. " пїЅ пїЅ пїЅ

What is viral load? " пїЅ 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. пїЅ пїЅ

The goal of treatment is to get your viral load below "detectable levels. " пїЅ That means there is so little virus in your blood that the test cannot even pick it up. пїЅ пїЅ

What are CD4 cell counts? " пїЅ 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 " пїЅ cells " пїЅ often called "CD4 cells " пїЅ or "T cells " пїЅ for short. пїЅ пїЅ

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 " пїЅ infections. Opportunistic infections are caused by germs that healthy people can usually fight off. In people with HIV, though, these germs can cause infection. пїЅ пїЅ

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. " пїЅ When your CD4 counts get back up over 200, you can stop the antibiotics. пїЅ пїЅ

How often should I have viral load and CD4 tests? " пїЅ How often you should be tested will depend on how your treatment is going and how recently you were diagnosed with HIV. пїЅ пїЅ

Some people need to be tested every 2 to 8 weeks. This might include people who: пїЅ пїЅ

  • 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. пїЅ пїЅ

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. пїЅ пїЅ

Can anything besides HIV affect viral load and CD4 test results? " пїЅ 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. пїЅ пїЅ

CD4 counts can go down because of a lot of things, including: пїЅ пїЅ

  • 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. пїЅ пїЅ

This topic retrieved from UpToDate on: Nov 04, 2014. пїЅ пїЅ

Topic 16937 Version 3.0 пїЅ пїЅ

Release: 22.8 - C22.208 пїЅ пїЅ

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