HIV Monitoring Test Basics

View as:|
1 of 7

Your HIV-positive test result only lets you know that you've been infected with HIV. To find out if it's time to get HIV treatment, you'll have to visit a health care provider and get two additional tests: a CD4 count and a viral load test.

This resource breaks down what it means to monitor these two important numbers. You'll want to have them checked a few times a year when you visit the doctor for monitoring. If you want, take some time to learn more about viral load tests or CD4/T-cell counts before you begin.

The CD4 Count Test

The CD4 count test, also known as the T-cell count test, gives an indication of the number of CD4 cells in your bloodstream. These cells help fight disease, so the more CD4 cells you have, the stronger your immune system is. After living with HIV for a while (if you don't take medications), the number of CD4 cells you have will usually fall. This is a sign that your immune system is being weakened.

A normal CD4 count for someone without HIV is usually between 500 and 1,600. Experts generally agree that it's best for your health to begin taking HIV medications before your CD4 count hits 500.

CD4 Count Explained

Healthy500 - 1,660Borderline Low350 - 500Low200 - 350Extremely Dangerous0 - 200

The Viral Load Test

Viral load means exactly what it sounds like -- it's an estimate of how much HIV is circulating in your blood. Generally speaking, your viral load is not considered as critical as your CD4 count in determining the health of your immune system. However, once you begin HIV treatment, it is a good measure of how well your HIV medications are working.

A viral load test measures the amount of HIV in a small amount (milliliter, or mL) of your blood. The most sensitive viral load tests currently used in clinics can detect as few as 20 copies of HIV per milliliter of blood. When your viral load test indicates that you have fewer than 20 copies/mL of HIV, your health care provider will tell you that your viral load is "below the limit of detection," or "undetectable."

This does not mean you no longer have HIV in your body. Though it is not technically impossible for someone who has an "undetectable" viral load to transmit HIV, studies show that there is virtually no risk of HIV transmission when a person's viral load is undetectable. Though it may be undetectable in your blood, HIV can hide out in other parts of your body -- called "reservoirs" -- and begin making more copies of itself were you to stop taking HIV meds. An "undetectable" viral load means that your medications are doing an excellent job of keeping HIV in check, both for purposes of your own health and for avoiding transmission to others.

Learn more about viral load tests, read stories from some of our community members about their first time reaching "undetectable," and find out more about viral suppression and HIV prevention.

HIV Drug Resistance Testing

Your HIV specialist should also take a look at your overall health with a general blood count test. You can also get an HIV drug resistance test. A resistance test will tell you if your HIV has already become resistant to any HIV medications.

How could this happen? The person who transmitted HIV to you may have been on HIV treatment, and his or her virus may have become resistant to one or more HIV medications. Transmitted along with HIV was resistance to certain drugs. It's often best to get resistance tests before you begin taking HIV treatment.

Dealing With HIV and Other Illnesses?

If you are coinfected with another chronic illness, such as hepatitis B or C, your physician may refer you to a liver specialist who also specializes in HIV. Make sure that you inform all doctors of coinfection, and that each of your doctors is in contact with the others.

Ask questions, or read answers, specifically about hepatitis and HIV coinfection in's "Ask the Experts" forum on hepatitis and HIV.

Track Your HIV/AIDS Tests

Your best bet is to go out and buy a notebook to take with you to all doctor's appointments. Decorate it, make it something that you love to look at! Write down all of your monitoring test results and take lots of notes. When you start taking medications, you can use this notebook to keep track of the names of your medications and when you're supposed to take them.

If you don't want to carry around a paper notebook and you want to embrace a digital alternative, you can use's secure, comprehensive health tracker tool. Using My Health Tracker, you can keep track of your test results, doctor visits and all the medications you're taking. There's even a note feature.