No Hiv, No Aids

Before starting HIV treatment, your doctor will ask you questions about your health, do a physical examination, and do blood tests. Blood tests will include a complete blood count, blood chemistry profile, a test for hepatitis B and C, a viral load test, and a CD4+ T cell count. Your doctor should also perform other tests for infections (such as syphilis screening, tuberculin skin test, and toxoplasma antibody test). Women should have a gynecologic examination with Pap smear and a pregnancy test. Your doctor also may do other tests.

Both the viral load test and the CD4+ T cell count will be done before you start HIV treatment.

Viral Load Test
The viral load test measures the amount of HIV in a sample of blood. Getting a viral load test before starting HIV treatment is important for two reasons.

• It shows how well the body’s immune system is controlling the virus.
• It provides a baseline measurement for viral load.

After you start treatment, your viral load will be compared to the baseline. This will help your doctor see how well the drugs are working.

At first, viral load testing should be done at two different times, by the same laboratory, using the same type of test, to ensure accurate results. Currently, the RT-PCR assay (Roche) and the NucliSens HIV-1 QT (bioMerieux) are the only viral load tests approved by the Food and Drug Administration (FDA). The bDNA (Chiron) viral load test is also commonly used, but is not FDA-approved.

CD4+ T Cell Count
The CD4+ T cell count is the number of CD4+ T cells in a sample of blood. There are two important reasons to have a CD4+ T cell count before starting treatment.

• It shows how well your immune system is working.
• It provides a baseline measurement of your CD4+ T cell count.

After you start treatment, your CD4+ T cell counts will be compared to the baseline. This will help your doctor see how well the drugs are working.