What's the relationship between viral load counts and CD4?
CD4 counts and viral load tests measure different things. Your viral load test measures how much HIV is in your body while your CD4 count measures the health of your immune system by counting how many CD4 cells you have. Your viral load is better for measuring how well your treatment is working, while your CD4 count helps healthcare workers to understand if you're likely to stay in good health.
Although different, your CD4 count and viral load are often linked. As your viral load goes up, HIV damages more of your CD4 cells causing your CD4 count to go down. When you start treatment your viral load will go down, which will allow your CD4 count to go up, as your immune system repairs and rebuilds itself.
In general, your CD4 count responds more slowly to changes in your body. Your viral load will go up and down more quickly in response to treatment working or failing, while CD4 counts take more time to change. This is why viral load tests are the preferred way of monitoring your treatment.
What can I do to manage my own care better?
It's important to build trusting relationships with your healthcare team, as you will be seeing them over a long time. The more you communicate with them and tell them how you're doing, the better care you will get.
To get the most out of your appointments, it helps to prepare and write down any questions that you have. This will help you remember if there are things you wanted to tell them. It's fine to interrupt and ask questions if you don't understand what your healthcare worker is telling you. You should understand any medication that you take, tests that you do, or any examinations and referrals that you have. The more you understand, the better because it helps you to manage your health and will make you feel more in control.
If you're seeing multiple healthcare teams for different health problems, they must have contact with each other and know what other health care or treatments that you're taking. This will help them ensure that there are no bad interactions.
If you're having problems, know where you can go to make a complaint. It could be a more senior health care provider or someone else in your community or healthcare system.
Manage your appointments well. You should try to make sure you know when you will next be seen before you leave and re-book any appointments that you can't make.
What other health checks will I get?
The health checks you get will depend on the treatment you are taking. You may also have different health checks depending on your CD4 counts. In general your health care workers will be interested in monitoring:
a) the glucose levels in your blood - these show how well your body is absorbing energy from food
b) the health of your liver - to make sure that you can process your antiretroviral treatment properly
c) your kidney function - to check they can remove waste from your body properly
d) as well as the amount of fats in your blood, your bone density and sexual health.
You should also be tested for other sexually transmitted infections, hepatitis B and C as well as TB.
Most of these tests will either been done with a blood test or urine sample. Your doctor should explain the tests they do, and you should report any other issues or changes that you notice in your health. This will help them give you the appropriate care.