Labwork : In This Corner - by Staff

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POZ Focus

Back to home » HIV 101 » POZ Focus » Labwork

Table of Contents

 
Blood Simple

Resistance Testing

CD4 Count

Viral Load

CBC

Chem-Screen

Who's Got You Covered?

We Shall Overcome

In This Corner

Down At The Lab

 
What You're Talking About
Let's Kick ASS - AIDS Survivor Syndrome (32 comments)

It's Time for a TV Dramedy Series About Life With HIV (27 comments)

AHF Campaigns Against PrEP as a 'Public Health Intervention' (25 comments)

True Story - An essay by a gay journalist and author who is tired of living in fear of HIV (17 comments)

Depression, God and Staying Alive... (blog) (17 comments)

Health Care is a Human Right (8 comments)
Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV


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In This Corner

by Staff

Lab results are useless without informed interpretation. POZ pits old theories against the latest thinking. Guess who wins?

OLD SCHOOL: When viral load goes up, CD4s go down.
NEW SCHOOL: This ain’t no seesaw. Yes, a high viral load (say, 100,000 copies) drives down your overworked CD4 cells, and dipping below 200 CD4s still puts HIVers at greater risk for scary infections. But hold on: We now know that some people sustain their CD4 counts even with detectable viral loads (say, 10,000 copies). In many cases, this surprising finding may reflect the effects of the HIV meds themselves: Certain mutations that reduce the strength of certain meds also weaken the virus. Does this mean viral load and CD4 counts are useless? Not at all; they’re just part of a bigger picture that includes tests for resistance and viral fitness. And remember: The trend over time is more important than a single reading.

OLD SCHOOL: Viral blips = bad news.
NEW SCHOOL: Blips don’t equal blues.
Everybody these days has their eyes on the prize: being undetectable. But what about a “viral blip”—when no-show HIV suddenly makes a reappearance on one test and then vanishes by the next? Although we now know that HAART can never completely rid your body of the virus, by the same token a blip—or even a sustained “breakthrough”—doesn’t spell doom for your current combo. If a blip gives you the jitters, analyze your adherence with Doc—there’s always room for improvement.

OLD SCHOOL: Drug resistance = treatment failure = oh, nooooo!
NEW SCHOOL: What, me worry?
Experts increasingly support the idea that just enough virus of just the right type may actually be a good thing—at least if the virus has mutated and become less “fit.” Top AIDS immunologist Mike McCune, MD, PhD, at UCSF’s Gladstone Institute, found that HIVers on “failed” regimens—with viral loads that had rebounded to between 1,000 and 10,000 copies—had higher-than-expected numbers of CD4 cells, meaning that their immune systems were making a comeback! McCune’s take-home: “Although it is preferable to have no virus at all, a detectable virus may not always be bad.”

OLD SCHOOL: “One-size-fits-all” treatment guidelines.
NEW SCHOOL: Guidelines need adjusting to fit you to a T.
Just because the guidelines are “official” doesn’t mean they’re set in stone. In fact, in 2003 they were revised to reflect not only new drugs on the market but new knowledge—the longer we use HIV meds, the more we learn about them. Women with HIV often have significantly lower viral loads than male HIVers. And although both sexes progress to AIDS at the same rate, ladies may do so with less virus. “It’s especially important for women to follow their CD4 cell count. If it has fallen, it may be time to initiate treatment, even if the viral load is still low,” says Kathleen Squires, MD, an HIV expert at the University of Southern California. Recent studies also found that African-American HIVers had lower viral loads than white HIVers.

OLD SCHOOL: It’s not all about numbers.
Viral load and CD4 cell count are best used to help guide decisions about when to start, stop and switch HIV meds. But other aspects of your life also figure, from genetic makeup and family medical history to mental health and readiness to stick to a pill schedule.
NEW SCHOOL: Some things never change.  —Emily Bass



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