I had doc appt today. My CD-4 is around 800 and VL 14,000. I'm not on meds yet and believe I was infected 8 years ago.

It is a big decision as to when to start meds. I often think I should just start now. Then, I talk to others who didn't need to start meds for 10 to 18 years after diagnosis.

Anyway, I asked today whether my immune system could be fighting the virus off. My doc first said a tropism test(or something like that) could be done to check CCR5 (or something like that). I apologize for not having all the right terminology. The point was this test may show whether I have better defenses. When I said I didn't have insurance, I was told the test is over $1,000 and then was told the test probably wouldn't tell me anything. There was definitely a change in attitude about what this test may show.

Is there a test that can give a person a better idea how good their immune system may be at fighting the virus--which could give some insights into when to start meds?

Thanks so much for all you guys do!

First, you don't need meds at this time. Given the length of infection and your normal CD4 count, I would recommend not starting HIV meds. Second, the tropism test that is referred to determines what kind of receptor (either R5 or X4) your virus uses to gain entry into CD4 cells and infect them. A new drug called maraviroc essentially blocks the CCR5 receptor and prevents HIV from getting in the cell. If you have R5 virus then maraviroc would work for you. If you have X4 virus then providers would not prescribe that drug for you. So, it is essentially a screening test used to determine whether this particular drug can be used. Now it turns out that most people have R5 virus, particularly with normal CD4 counts like you, but when HIV infection becomes more advanced people can see a switch in their virus to X4. So the test doesn't really determine how good your immune system is working.