TESTING
Why is there so much testing? The results and numbers are the building blocks for creating your treatment plan. The more the doctor knows about you, the easier it will be to construct a detailed and personalized plan tailored just for you. These numbers will also start a graph of your health progress and with this information you can see how fast and how much better you are becoming. Information is power: so you must get right back to a clinic or a hospital and get all of the tests done, not tomorrow, today!
Viral Load
This test is the most important test to have, because you must know how much of the HIV virus is present within your system. This number is a valuable indicator to help your doctor to effectively prescribe medications for you. If you have recently been infected with the HIV virus you will probably have a very high viral load which is based on the number of parts per million. Try to not obsess over this number because it can vary drastically from person to person from 1,000 to well over 1,000,000. Many sleepless nights are spent worrying over this number, its time to just let it go because very soon the number will be almost zero.
Now in the future when your viral load does go below 40 you will be considered undetectable (UD) which does not mean that you are cured because the virus will always be present in your body however it means that there is so little of the virus that it is no longer damaging your immune system and you are no longer capable of transmitting the virus. Becoming UD means that your immune system will start to recover to normal levels because the HIV virus is no longer reproducing in your body and you can lead a normal happy life. However after becoming UD if you do go off your medications or miss doses the HIV virus will begin replicating immediately and at a much faster rate. This one test will be the cornerstone of your first 6 months of care. It will need to be repeated about 30 days after starting medication and again after 3 months. When you have 3 consecutive UD tests you probably can then do a viral load test only twice a year.
CD4 Count
This measures the number and percentage of your white blood cells that you have in your body. CD4 cells are a kind of white blood cells that are a vital part of your immune system that fights off infections and illness. For the moment these numbers are not something you should be too worried about if the numbers are not too low but the results will factor into your initial medications and your treatment in a few months. The normal range is 500-1200 parts per million and between 30-40% of white blood cells. The higher the number the better your immune system is functioning. The HIV virus attacks and destroys these cells which then causes you to become ill because of normal infections that your body would naturally just fight off. Soon after starting your medication your CD4 numbers should start to rise but it does take quite awhile to get the numbers back to your previous levels. There is no way to make them rise faster: only a proper diet, adequate sleep, healthy living, and some research suggests that selenium tablets might be effective. Do not be fooled by any miracle CD4 cures, pills, or supplements they are all false claims. So what do the results mean?
If you have a result of 350/30% or over there is not much to worry about and your doctor will advise you more on what this means. If the result is lower you will need to take extra care of your health. If you do happen to have a CD4 count of 200/15% or below your doctor will advise you on special precautions, vaccinations, and medications you will need to take until the number recovers to a higher level.
STD Screen
Simple and routine tests for syphilis, gonorrhea, chlamydia, herpes 1-2 and hepatitis A-B-C should be taken to ensure that there are no current infections that need treatment that might cause medications to interact. Sometimes people are more nervous about taking these tests but don’t be, they are very normal parts of routine physicals. If you are infected with an STD then you must have it treated immediately so that you can begin your HIV medications. Most STDs are completely curable with only a few days of antibiotics, left untreated they can develop into serious problems in HIV positive individuals. Most STD tests are done with a simple blood test however sometimes chlamydia does require a swab from the genital area. Hepatitis infections are a more serious health problem for HIV positive people so you will need to test for all 3 strains A-B-C. These results take from 1-7 days. If you do have hepatitis your doctor will advise you on the best treatment options available. Remember these are normal tests that will speed along your HIV treatment so do not delay.
Liver/Kidney
These are basic health checks and are completely routine. The results will help you and your doctor decide which medicines are the best for you. Liver/kidney function is important for everyone and even more important for HIV positive people. These functions will be tested before you start medication, about a month after, then 3 months later. Then a regular yearly check up every 3-6 months will be fine. Several anti HIV drugs in a tiny percentage of people can cause some liver/kidney problems, stopping or changing the medications will stop the symptoms. In the first year of taking your medication you will be checked regularly for kidney/liver functions, after three sets of clear test results, monitoring will probably be only every 6 months just as a routine precaution.
Resistance
This checks for your genetic disposition for resistance to certain drugs. These results will save time when finding the right combination of drugs for you. There are 6 classes of medications to fight HIV and 25 medicines within those classes. Certain genetic mutations occur in people and different strains of HIV causing them to become drug resistant. There is also a genetic test for HLA-B*5701 to predict hypersensitivity to the drug abacavir which could be useful if you are thinking of choosing some of the newest combination drugs.
These tests are expensive but will help when choosing the best medications for you. These tests require longer waiting times to get results usually 7-14 days. In the extremely unlikely event that you do have any resistance or sensitivity these test results will help your doctor prescribe medications for you. If you are unable to have these tests just inform your doctor and they will start your medications with this in mind. If there is a problem with your medications in the future you will have to do the tests as a precaution, however genetic resistance and sensitivity is presently still very rare.