Q and A


I am recently infected should I get a STARHS test?

My history is below. Both tests were taken at the main hospital GUM clinic, where they tell me they test for p24 antigens and antibodies:

Nov 15 2010 – negative HIV test
Jan 20 2011 – positive HIV test, bloods taken a day later with viral load 5,000, CD4 over 400 with a 33% CD4. I am due to see the doctor for the 1st time next week.

I have 2 questions:

(1) Is it worth me asking the doctor for a STARHS test – I’m not quite sure why I would want this or what it would show?

(2) Considering my testing history, is it likely that my CD4 will increase anymore? I’m not sure if my results are good, bad or average or is it not possible to say yet?


Thank you for your question.

I am sorry to hear about your recent diagnosis. I hope you are managing to deal with this new diagnosis? I know there is a lot to take in right now. For some helpful support written by other positive people who have been through a similar situation please follow this link.

I will answer your questions as you numbered them below:

(1) The STARHS test is used to see if someone was infected in the previous six months. STARHS stands for Serological Testing Algorithm for Recent HIV Seroconversion. It is also sometimes called the RITA test which stands for Recent Infection Testing Algorithm.

This test is provided free of charge from your clinic and anyone in the UK can ask for it if they think they have been recently infected. The test is a slightly less sensitive form of the HIV antibody test called the ELISA test. For more information about this test please follow this link.

Knowing your infection date is helpful as it can tell you if you are a fast, regular or slow progressor. It is generally a good idea to have a STAHRS test if you know you are newly infected.

For more information on STARHS and when it is used please follow this link.

(2) Your CD4 count and your viral load are both very good. It is difficult to know what CD4 count is ‘normal’ for you as you do not know what your CD4 count was before you were infected. Everyone is different and the average negative person generally has a CD4 count within the range of 500-1600, although some people do sit outside this range.

As you are recently infected it is possible that your CD4 count will increase over the next few months. However, CD4 counts do fluctuate and can depend on lots of things like whether you have been exercising, the time of day the test is taken, lab error, if you have had enough sleep, if you have an underlying infection, your diet etc. However, it is likely that your CD4 count will gradually decrease over the next few years until you decide to start treatment. Once on treatment, whether most people see an increase in their CD4 count within the first 6 months. Some people take slightly longer and a very few people find their CD4 count does not increase once on treatment.