It is important to have information to better understand the implications of having HIV and how treatment works:
There are two important blood tests which help to indicate how much damage HIV has done to your immune system and predict your future health; CD4 count (which reflects the health of your immune system) and your viral load (which measures the level of active virus in your blood).
What is a CD4 count?
The number of CD4 cells in a cubic millimetre of blood is known as your CD4 count. This is determined by a specific blood test.
What is a viral load test?
The viral load test measure the amount of HIV circulating in the blood. It is good to have it as low as possible and for most people this is less than 50 copies/mL of blood, which is referred to as an ‘undetectable level’.
What does your CD4 count and viral load mean to you?
After living with HIV for a period of time, most people’s CD4 count will usually decrease – which means that the immune system is being weakened. The lower the CD4 count, the higher the risk of becoming unwell. A CD4 count between 500 and 1,200 cells/mm3 is normal for someone without HIV. While the CD4 count is above 300 cells/mm3, you may still feel in reasonably good health, however, the inflammation processes caused by the HIV itself may still be doing some unseen harm.
If the viral load is high, CD4 cells tend to be destroyed more quickly. The aim of medical treatment is to keep the viral load as low as possible; for most people this is less than 50 copies/mL of blood, which is referred to as an ‘undetectable level’.
What is Antiretroviral Therapy (ART)?
There are several different types/classes of drugs that work at different stages of the HIV life cycle. ART (also known as Highly Active Antiretroviral Treatment or HAART) refers to a combination of three or more drugs to treat HIV infection.
HIV drugs work by stopping the virus from replicating, which in turn lowers the viral load and allows the immune system to recover to some extent.
Before you start treatment
When choosing your first treatment combination it’s important to consider other parts of your life, such as your work schedule, travel plans and family commitments. The medical team will also want to know about any other medications you are currently taking (including recreational drugs).
When deciding the right time to start treatment, be sure to consider the level of your commitment to treatment. Also take into account your readiness to begin treatment, which is a combination of factors such as feeling knowledgeable, having a belief in the benefits of treatments and confidence in your ability to tackle any challenges (such as side-effects) should they arise. You will also need support, ideally both from your health care team and from those people who are important to you and who can be around to help.
The benefits of taking ART
The benefits of starting treatment as soon as possible include a reduced risk of becoming ill or dying.
Starting treatment relatively early is also beneficial. It has been shown that people who start therapy at a CD4 cell count above 350 cells/mm3 are more likely to have longer survival compared to those who start treatment at lower CD4 counts. However, whatever your starting point, research has shown considerable improvements in immune-related health and survival for those taking these treatments. Many people report having more energy once viral load reduces.
Once you are on the treatment
It’s important to remember that taking your treatment reliably, following the instructions given to you by your prescriber is crucial to success. This is termed ‘adherence’ and it helps considerably to reduce the risk of developing drug resistant virus by maintaining constant and effective levels of medicines in your bloodstream. For this reason, always try to take the correct dose at the correct time and follow any food restrictions and any additional instructions given to you.
Please refer through to the treat.info slide deck for further information about starting on treatment.