Seeing an HIV Doctor

Terms Used in This Fact Sheet

Baseline: an initial measurement (such as CD4 count or viral load) made before starting therapy and used as a reference point to monitor your HIV infection. Kidney function tests: blood and urine tests that determine if your kidneys are working properly. Advertisement Liver function tests (LFTs): tests that measure the blood levels of liver enzymes (proteins made and used by the liver) to determine if your liver is working properly. Urinalysis: test looking for the presence of glucose, protein, blood, or any signs of infection in a patient's urine.

I Am HIV Positive. What Kind of Doctor Do I Need?

Your doctor (or other health care provider) should be experienced in treating HIV and AIDS. You may want to see an infectious disease specialist. You will need to work closely with your doctor to make informed decisions about your treatment, so it is important to find a doctor with whom you are comfortable.

What Can I Expect at the Doctor's Office?

Your doctor will ask you questions about your health, life style, conduct a physical exam, and order blood tests. This is a good time to ask your doctor questions. Write down any questions you have and take them with you to your appointment.

Women should have a pregnancy test (see HIV During Pregnancy, Labor and Delivery, and After Birth Fact Sheet series) and a gynecologic examination with Pap smear.

What Questions Should I Ask My Doctor?

You should ask your doctor about:

• Risks and benefits of HIV treatment

• Other diseases you may be at risk for

• How your lifestyle will change with HIV infection

• How you can avoid transmitting HIV to others

• How you can achieve and maintain a healthier lifestyle

What Tests Will My Doctor Order?

It is very important to have a CD4 count and a viral load test done at your first doctor's visit. You should also have drug resistance testing. The results will provide a baseline measurement for future tests.

• CD4 count -- CD4 cells, also called CD4+ T cells or CD4 lymphocytes, are a type of white blood cell that fights infection. HIV destroys CD4 cells, weakening your body's immune system. A CD4 count is the number of CD4 cells in a sample of blood.

• Viral load test -- A viral load test measures the amount of HIV in a sample of blood. This test shows how well your immune system is controlling the virus.

  The two viral load tests commonly used for HIV are:

  • HIV RNA amplification (RT-PCR) test

  • Branched chain DNA (bDNA) test

• Drug resistance testing -- Drug resistance testing determines if an individual's HIV strain is resistant to any anti-HIV medications. HIV can mutate (change form), resulting in HIV that cannot be controlled with certain medications.

To ensure accurate results, viral load testing should be done at two different times, by the same laboratory, using the same type of test. The results of different types of tests may differ.

Your doctor may also order:

• Complete blood count

• Blood chemistry profile (including liver and kidney function tests)

• Urinalysis

• Tests for other sexually transmitted diseases (STDs)

• Tests for other infections, such as hepatitis, tuberculosis, or toxoplasmosis

Am I Ready to Begin HIV Treatment?

Once you begin taking anti-HIV medications, you may need to continue taking them for the rest of your life. Deciding when or if to begin treatment depends on your health (see Starting Anti-HIV Medications Fact Sheet) and your readiness to follow a treatment regimen that may be complicated. You and your doctor should discuss your readiness to begin treatment as well as strategies to help you follow your treatment regimen (see What is Treatment Adherence and Adhering to a Regimen Fact Sheets).

If My Doctor and I Decide to Delay Treatment, Will I Need to Have My CD4 Count and Viral Load Tested Again?

Yes. HIV infected people who have not started anti-HIV medications should have a viral load test every 3 to 4 months and a CD4 count every 3 to 6 months. You and your doctor will use the test results to monitor your infection and to decide when to start treatment.

For More Information

Contact your doctor or an AIDSinfo Health Information Specialist at 1-800-448-0440 or http://aidsinfo.nih.gov.

This information is based on the U.S. Department of Health and Human Services' Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents (available at http://aidsinfo.nih.gov).