Positive? How are you feeling?

January 2007     View PDF     En español

HIV basics

Every HIV-positive woman should know basic facts about HIV disease. There’s plenty to learn, and lot’s of time to do it. But for starters, here are a few basics.

HIV infects certain cells in your immune system that play a key role in fighting infections. When you lose these cells, your immune system weakens and loses its ability to fight off infection and disease.

Stopping or slowing HIV from destroying immune cells is one goal of an anti-HIV strategy. To monitor HIV and your immune health, two simple blood tests are used. A viral load test tells you how much HIV is present and how fast it’s reproducing itself in your bloodstream. The CD4+ cell (commonly called T cell) count gives you a rough measure of the strength of your immune system and the degree to which it has been damaged.

It’s recommended that you get these tests taken regularly (every 3–6 months). If you see dramatic changes in the numbers or switch anti-HIV therapy, you may want to get these tests more frequently.

Viral load testing: Interpreting the results
Low viral load (generally below 10,000 copies/ml) indicates that HIV is reproducing slowly and the risk of HIV progression is low.

High viral load (above 100,000 copies/ml) indicates a higher level of viral activity and thus a higher risk for HIV disease progression.

Low, stable, or decreasing viral load level is considered a good thing. A high or increasing level demands attention and is often a major factor in deciding when to start or switch treatment.

Remember to consider CD4+ cell count. Together, the test results more accurately indicate the risk for disease progression than viral load results alone.

CD4+ cell counts
CD4+ cell counts below 200 indicate a significant risk of getting opportunistic infections (OIs). These are infections that take advantage of the “opportunity” of a weakened immune system. When CD4+ cell counts fall below 50, there’s great risk of serious OIs. At this stage, CD4+ cell counts—rather than viral load tests—more reliably predict HIV disease progression.

It’s normal for tests to vary from one to another. So you should avoid panicking if you happen to see a number that seems abnormally high or low. Any time you get what looks like an alarming result, you should repeat the test for accuracy. Most doctors discourage people from changing therapy based on any single test result. Instead, it’s the change over time that should guide treatment decisions.

Remember!
Pay attention to trends, not just one test or absolute numbers. You should never make a treatment decision based on one result—repeat the tests and confirm the numbers before starting, switching, or stopping therapy.