Your activity: 8 p.v.

Patient education: Tests to monitor HIV (The Basics)

Patient education: Tests to monitor HIV (The Basics)

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, it's important to have your viral load tested regularly. This test helps your doctors check on your infection and shows 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. These are often called "CD4 cells" or "T cells" for short.

The number of CD4 cells you have has a lot to do with how well your body can 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's bodies 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 usually stop the antibiotics after a few months.

How often should I have viral load and CD4 tests? — How often you should be tested will depend mostly on your CD4 count and how your treatment is going.

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

People whose HIV seems to be under control and who are not changing medicines or doses might go 6 months or longer between testing. Some people might not need CD4 tests at all.

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.

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

More on this topic

Patient education: HIV/AIDS (The Basics)
Patient education: Starting treatment for HIV (The Basics)
Patient education: Vaccines for adults with HIV (The Basics)
Patient education: Preventing HIV after unprotected sex or needle-sharing (The Basics)
Patient education: Blood or body fluid exposure (The Basics)

Patient education: Testing for HIV (Beyond the Basics)
Patient education: Initial treatment of HIV (Beyond the Basics)
Patient education: Symptoms of HIV (Beyond the Basics)
Patient education: Tips for taking HIV medications by mouth (Beyond the Basics)
Patient education: HIV and pregnancy (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 02, 2023.
This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms ©2023 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
Topic 16937 Version 10.0