CD4 and viral load

CD4 and viral load… Which one should you focus on? Both!  says Otieno.

Your CD4 count is a good overview of how well your immune system is working and how much damage HIV has done to it. Viral Load (VL) will show you how active the HI Virus is in your body.

It’s really important to get a number of readings of both, over the course of a year or two, rather than making a decisions based on any single test result. Results change constantly, so it’s best to get several tests and see how they compare over time. A CD4 count below 200 is an immediate cause for worry because you have a much higher risk of developing an opportunistic infections (OI’s).

CD4 Cell Count  - CD4 cells are the immune system’s leaders, issuing commands to nearly every other cell. For people living with HIV, CD4 counts are the No. 1 sign of how strong or weak the immune system is. Most experts recommend CD4 measurements every three to six months—more often if they’re lower or changing quickly. Low CD4 counts are a sign that the HIV is in need of treatment. HIV may cause other numbers (e.g. neutrophil counts) to fall as well, which may call for treatment. Talk to your healthcare provider about your options.

HIV Viral Load measures how much HIVirus is in your blood. This information will help you and your healthcare provider make decisions about starting HIV treatment (ARV’s) and will show whether the medications are working or not. Fewer than 50 copies of HIV per mL—about a teaspoon of blood—will show as “undetectable”. Results can range from undetectable up to millions of copies per mL

When should you have a viral load test done? If you can, at the same time as you get your CD4 counts done—typically every 6 months or more frequently, based upon your health care providers recommendation. —then between you, you can monitor your HIV infection and see if any change in treatment are needed. A sudden or dramatic change in viral load may call for an immediate repeat test.

An undetectable result doesn’t mean the virus has left your body, but rather indicates the success of your treatment and less chance of the disease getting worse. If you are on HAART (Highly Active Antiretroviral Treatment/ ARV’s—a potent combo of HIV-fighting drugs), an undetectable viral load is considered the ultimate prize and shows that your treatment is working.

If you’ve just started treatment, this could take several months— another test in two or three months will tell for sure. Even if the viral load is considered undetectable, it may occasionally bounce up to small but measurable amounts. Continual, detectable viral load, while you’re on HAART/ARV’s, is cause for concern, as it signals that your treatment isn’t controlling the virus. You and your healthcare provider need to talk about switching treatment.