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Frequency of VL/CD4 counts

Jun 8, 2016

Hello Dr, I am currently on triumeq (and many antibiotics as prophylaxis) with an UD viral load and a low CD4 of 64 which has been slowly rising. When I first started treatment in October 2015, my HIV doctor wanted me to do bloodwork every month since I had a high viral load of 108,000, a CD4 of 20 and put on many antibiotics in addition to trimeq. Now that I am UD, my doctor says monthly checks are not necessary and that every 3 months or 4x a year is ok since I am feeling good, put all my weight back on and now just waiting for my cd4 to go up. So my question is when does it happen that I will only need to do VL/CD4 twice a year or even once a year? When my CD4 is above 200? What happens if I don't do my labs exactly every three months? THanks, J

Response from Dr. Henry

The recommended frequency of surrogate marker lab testing in HIV patients doing OK on treatment (suppressed viral levels) has been decreasing. For patients with suppressed HIV levels checking every 6 months is reasonable. Once the CD4 count is > 200-350 checking that level every 6 months is also reasonable in the setting of suppressed HIV levels (that is key marker for success of regimen). Once the CD4 count > 500 then checking the level yearly or even less often is current recommendation (again in the setting of suppressed HIV level).KH



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