Question
How often should my viral load be tested?
7 November 2009. Related: All topics, CD4 and viral load, Other tests.
I tested positive in April 2009 and I think I might have been infected around January of the same year. Through a lot of reading I have finally come to terms with my diagnosis and feel I am doing OK and getting on with my life and projects.
I do want to manage my infection properly and though I am very happy with my hospital and care there are a few details I would like to clarify.
I get tested for CD4 every 4 months which by the way was 600 the last two times. They also check for liver function etc. My question is why I do not get tested for viral load every 4 months as well? I have read that people with consisting high viral load should start treatment earlier disregarding of CD4 count.
Am I entailed to ask for a viral load test every 4 months as well? I would like to know my rights as not always is that easy to access the right care through the NHS and sometimes I feel I am asking for a big favour rather that my statutory rights as a tax payer.
Answer
Thanks for your question and for being able to post the answer online.
UK guidelines for monitoring someone not yet on treatment include routine tests every 3-4 months, so the timing of your tests are fine, especially if your CD4 count is still stable and high. This usually includes a full blood count (CD4 and others), viral load and others (liver function etc).
Some clinics modify this based on studies that show that:
i) for people not on treatment with high CD4 counts and low viral load, that a viral load test once or twice a year is probably fine; and
ii) for people on stable treatment with high CD4 counts and undetectable viral load, that a CD4 counts once or twice a year is probably fine.
When not on treatment, your CD4 count is more important and when on treatment checking your viral load is undetectable is more important.
The clinics that do this should have the flexibility for you to ask for more frequent test if you want or need this, but it probably won’t add much that is useful.
If your CD4 count stats to drop significantly, then your viral load would then be routinely checked more frequently again.
You didn’t give your last viral load test but I would think it was very low.
The 3-4 monthly tests are more based on historical practice that any proven need. When people are stable, it might be ok to monitor much less frequently just as in more complicated situations they are sometimes tested every month.
If you are not happy, then speak to your doctor or health advisor about your concerns. If you are still unhappy after hearing their explanation and still want more frequent monitoring then you could change to a clinic that still monitors both test more frequently. If you call the i-Base phoneline we can provide more details.
I’m not sure that there would be any medical advantage to this though in terms of any benefit to your health.
It is good to hear that you are keeping on top of everything and that life is getting easier again as you come to terms with living with HIV.
Hi Nolwazi,
A persons viral load should become undetectable within 1-3 months of starting medication. So yes, its very possible that your viral load will be undetectable by the time you give birth. There’s more about pregnancy here: http://i-base.info/guides/pregnancy
hi i have 4 months before i deliver i stopped taking ARVS when i was two months pregnant and now my viral load has increased to 2730 and i’m scared that my baby is already infected. iam back at using ARVS can my viral load decrease before i give birth in june? i intend not to stop taking them. help i’m scared.
Hi Zaharah,
I’m sorry to hear of your diagnosis. But I’m not sure about your question.
Are you on HIV meds, and what are your blood tests results? Do you have access to treatment and care?
Hi, am Zaharah i was married for four years and divorced but after i began my HIV tests and results were negative for the last four years.recently in 2018 april i went for HIV test before marrying again, results came positive and my pattern whom am to marry was negative but before since divorce not hard sex.what does that mean? Thanks
Hi Stanley,
These two different tablets are very similar. The main drug in both is efavirenz. So it’s unlikely that the new tablet wouldn’t be as good.
But we are not doctors at i-Base. Please talk to the clinic about your symptoms. It’s important to find out what’s causing them.
Hi, following unrelenting anal pain with blood after bowel movement, doctors initially prescribed anusols for 2 months but in vain, my wife advised we test for hiv to which I obliged, I tested positive in March this year,with a cd4 of 291,and started treatment( Tenofovir300mg/ Emtricitabine 200mg/Efavirenz600mg,this helped me gradually untillthe fissures disappeared, after seven months me n my wife moved to east africa with a referrall letter,but the clinic we go to happened not to have the exact combination of drugs, so the doctor started us on Efavirenz600mg/ Lamivudine300mg/Tenofovir Disoproxil fumarate300mg, the yellow tablet, as it was the available medication,it’s now a month since we started but I am experiencing anal pains with stains of blood again when constipated, though not as worse as was before we started medication earl this year, could it be that this new combination of Arvs does not match our blood type and the virus is replicating the more?hence weakening immune systems?..please advise
Hi Comfort,
What country do you live in?
I have been on drugs but haven’t run viral load test for a year now because of my centre. What do I do?
Hi Bango,
Thank-you for your message. It’s great to hear how well you have responded to treatment! Guidelines about how often CD4 counts should be done vary between different countries. In the UK people stable on ARVs are recommended to have a CD4 count every 3 or 6 months, depending on their viral load. In the UK viral load testing is recommended every 3-4 months. The main aim of viral load testing is to pick up any resistance to medication early on. In some countries this test is very expensive. It’s up to you whether you feel it’s necessary for you to have it done. You might like to read more about viral load testing to help you decide.
Could you check the name of the drug you asked me about? I can’t find any drugs called Cotramotazene but I think it’s likely you mean Cotrimazine or Cotrimoxazole. These are names for a type of antibiotic. This is recommended for anyone whose CD4 count is under 200. It protects against a chest infection called PCP and other infections. If you have never had these problems it is likely that you will be able to stop taking this now, although you should check with your doctor first.
You’re right that science has made it much easier to control HIV. Recent studies have showed that life expectancy of an HIV positive person on ARVs is close to, or even the same as an HIV negative person. Unfortunately not everybody has access to ARVs that needs them. And there’s still a lot of ignorance around HIV treatment. People do still die of AIDS and HIV left untreated is still life threatening. But with better information and access to drugs this gets better everyday, and we can realistically hope for a day where nobody dies of AIDS anymore.
I tested HIV positive in 2010 with a CD4 count of 160. I have started ARV treatment and my last CD4 count was 462. How often should I go for CD4 count now on? Is there any need for me to have a Viral Load test? At what stage will my doctor stop me from taking Cotramotazene?
When I had my HIV test, I wasn’t sick and since then have be never been that sick save for ‘normal colds’. I have gained so much confidence in the ARV therapy, and sometimes wonder why AIDS should be treated as ‘life threatening’ as people take it.
Why is AIDS considered life threatening? Why do people say there is no treatment of HIV when science has made ‘controlling’ the infection so successful?