Checking my progress
Your doctor will regularly undertake tests to see how your immune system is functioning. The two main tests measure your viral load and your CD4 cell count. The results of these tests allow your doctor to monitor how your HIV infection is progressing. Your doctor can then provide advice on when you should start treatment or alter the treatments you are taking.
Viral load HIV multiplies by copying itself within your body. Your viral load indicates how active HIV is, damage to your immune system, risk of future damage to your immune system and risk of serious HIV-related infection. Your viral load also indicates how well your treatments are working or whether you should start treatment.
A viral load test is a simple blood test that measures the amount of HIV in your bloodstream. The lower your viral load, the better.
If your viral load is high and you start taking treatments, your viral load should go way down. Your doctor will aim to get it down to an ‘undetectable’ level. That means you still have HIV but there is so little it doesn’t show up in the usual tests.
An undetectable viral load will greatly reduce the risk of transmitting HIV although it does not eliminate it. A viral load test measures HIV in blood but your viral load can be higher in other body fluids such as semen and vaginal fluid, particularly if you have a sexually transmissible infection. Talk to your doctor about your particular circumstances if you are thinking of relying on low viral load as a substitute for safe sex.
What your viral load means
- High viral load (greater than 100,000 copies/mL) – There is a lot of HIV in your blood. This can do a lot of damage, make you sick and makes it easier to pass on HIV to someone else.
- Low viral load (fewer than 10,000 to 30,000 copies/mL) – HIV is being controlled and is unlikely to make you very sick. It is not as easy to pass on HIV.
- Undetectable viral load (less than 20 – 50 copies/mL) – Only a very small amount of HIV is in your blood. This should keep you well and makes it unlikely you can infect someone else.
CD4 Count CD4 cells are a critical part of your immune system. A person with a healthy immune system usually has between 500 and 1500 CD4 cells per millimetre of blood. HIV infects and destroys CD4 cells until they are so depleted your immune system does not work properly. The CD4 test is a blood test that identifies how many CD4 cells you have and how strong your immune system is. If your CD4 count is low, you are more likely to get sick. If you go on treatments, your CD4 count should go up considerably, which will stop you from getting sick.
- More than 500 cells/mm – Your immune system is still relatively healthy but depending on your general health it may be useful to start treatment. Talk to your doctor about how starting treatment might benefit your health.
- 350 to 500 cells/mm – Your immune system appears weakened. Think seriously about starting treatment.
- Less than 350 cells/mm – Your immune system is very weak. Start treatment immediately.