HIV/AIDS Monitoring and Treatment

How is HIV infection monitored?

HIV infection is usually monitored by your medical practitioner using a combination of blood tests and presenting signs and symptoms. Your CD4 cell count will provide an indication of the state of your immune system and this count usually drops as the infection progresses. A healthy person who is not suffering with any chronic disease and is not HIV-positive will usually have a CD4 cell count of 900 cells/uL or more.

Another factor is your viral load. Usually the viral load (amount of viral RNA copies in the blood) increases as the CD4 cell count decreases. This relationship between CD4 cell count and viral load differs among individuals and there is no way of estimating your viral load based on your CD4 cell count. It is imperative that you discuss your case with a medical doctor even if you have been self-monitoring your HIV infection through a private laboratory.

Certain signs and symptoms and the presence of other conditions considered to be AIDS defining illnesses are recorded and monitored by your medical doctors. Commencement of appropriate treatment is decided upon by a combination of monitoring factors – your CD4 cell count, viral load and the presence of AIDS defining illnesses.

Treatment of HIV/AIDS

There is only one effective treatment option for HIV/AIDS and that is anti-retroviral therapy (ART). While other drugs, like antibiotics and antifungals, can assist with reducing the chances of opportunistic infections, they are not effective against HIV infection itself. Anti-retrovirals (ARV’s) is the therapy of choice and can greatly increase your lifespan.

Typically ARV’s are dispensed when you meet one or more of these criteria :

  • A CD4 cell count of less than 200 cells/uL (medical aids in South Africa may have different criteria)
  • A viral load greater than 100,000 cp/ml
  • The presence of one or more AIDS defining illness

Depending on your response to the ARV’s as well as viral resistance, your supervising doctor may change your ARV’s as he deems fit. This is essential in reducing your viral load and allowing for your CD4 cell count to improve. Always follow the guidelines for your ART and medication should be used accordingly. Failure to do so reduces your therapeutic options in the long run and contributes to viral resistance.