(Last updated 3/1/2016; last reviewed 3/1/2016)
Testing positive for HIV often leaves a person overwhelmed with questions and concerns. It’s important to remember that HIV is a manageable disease that can be treated with HIV medicines. HIV medicines can’t cure HIV, but they help people with HIV live longer, healthier lives.
The first step after testing positive is to see a health care provider, even if you don’t feel sick. Prompt medical care and treatment with HIV medicines as soon as possible is the best way to stay healthy.
People with HIV work closely with their health care providers to decide what HIV medicines to take. Making these treatment decisions begins with an HIV baseline evaluation.
An HIV baseline evaluation includes all the information collected during a person’s initial visits with a health care provider. The HIV baseline evaluation includes a review of the person’s health and medical history, a physical exam, and lab tests.
The purpose of an HIV baseline evaluation is to:
People newly diagnosed with HIV infection have many questions. If you’ve just tested HIV positive you may have some of the following questions:
The following lab tests are included in an HIV baseline evaluation.
A CD4 count measures the number of CD4 cells in a sample of blood. CD4 cells are infection-fighting cells of the immune system. HIV destroys CD4 cells, which damages the immune system. A damaged immune system makes it hard for the body to fight off infections. Treatment with HIV medicines (called antiretroviral therapy [ART]) prevents HIV from destroying CD4 cells. The higher a person’s CD4 count is, the better.
ART is recommended as soon as possible for everyone with HIV, no matter how high or low their CD4 count is. However, a low CD4 count (below 200 cells/mm3) increases the urgency to start ART.
The CD4 count is also used to monitor the effectiveness of HIV medicines once ART is started.
A viral load test measures how much virus is in the blood (HIV viral load). A goal of HIV treatment is to keep a person’s viral load so low that the virus can’t be detected by a viral load test.
Drug-resistance testing identifies which, if any, HIV medicines will not be effective against a person’s strain of HIV. Health care providers consider a person’s drug resistance test results when recommending an HIV treatment regimen.
Testing for sexually transmitted infections (STIs)
Coinfection with another STI can cause HIV infection to advance faster and increase the risk of HIV transmission to a sexual partner. STI testing makes it possible to detect and treat any STIs promptly.
An HIV baseline evaluation also includes other tests, such as a blood cell count, kidney and liver function tests, blood glucose and blood fat level tests, and tests for hepatitis.
Before starting treatment, people with HIV must be prepared to take HIV medicines every day for the rest of their lives. A baseline evaluation can help to identify any issues that can make it difficult to take HIV medicines every day and exactly as prescribed (called medication adherence).
Issues, such as lack of health insurance or alcohol or drug abuse, can make medication adherence difficult. Health care providers can recommend resources to help people deal with any issues before they start taking HIV medicines.