Laboratory Test For Monitoring HIV Treatment!
The number of C.D.-4 cells. What are C.D.-4 cells?
The number of C.D.4 cell shows the immune power of a body. Whenever any types of micro-organisms like bacteria, virus or other germs enter into our body; these CD-4 cells get activated & resist these germs to protect the body. Saying it in a simple way, C.D.4 cells are the soldiers for body protection & germs are the enemies attacking the body.
The strength of C.D.4 cells in a body is important for the treatment of HIV. The number of C.D.-4 cells in a normal body is 400-1500. When this goes below 500, a body is liable to show the symptoms & troubles of HIV. One should start the treatment of HIV irrespective of the strength of C.D.-4 cells or symptoms. The current research shows that one should start the treatment immediately after the detection of HIV.
- When the strength of C.D.4 cells go below 200 & is found to have other diseases, the person is said to have AIDS.
- The strength of C.D.-4 cells goes on changing. The strength will be different in the morning, afternoon & evening.
- The strength of C.D.-4 cells will be less in case of other diseases or even during pregnancy.
- Every HIV patient should get him the strength of C.D.-4 cells checked at the interval of 3-6 months.
- If the strength of C.D.-4 cells is found increasing, it shows that the treatment is proper, effective & the control over HIV is achieved.
- If the strength of C.D.-4 cells is found decreasing, the treatment should be started immediately.
- If the strength of C.D.-4 cells is found to decrease even after the treatment, the drug resistance or treatment failure may be checked.
- If the strength of C.D.-4 cells goes below 250, the medicine namely Co-trimaxozale is given to protect the body from some serious diseases.
Resistance TEST -
It sometimes happens that the virus cannot be controlled even after the medications. Virus goes on increasing & the strength of C.D.-4 cells goes on decreasing. This shows that the effect of medicines on the virus is very low or is not there. This is called resistance. Resistance check is carried out to check the resistance. In this test, nearly 20 medicines are tested on the virus in the laboratory. Each & every medicine is tested for the effectiveness of the virus. Depending on the report of this test, 3 medicines are given which are effective. The resistance is mainly caused due to -
- Irregular & untimely treatment.
- HIV virus continuously changes its form which is called mutation.
To prevent resistance.
The chances of resistance can be reduced. For this, the growth of the virus should be prevented. The best way to prevent growth is retroviral medicines to be taken regularly & punctually.
The resistance test is little costly & costs Rs. 15000-20000. The result of the test is obtained within 15-20 days.
If the HIV test is positive, the doctor will recommend some of the following required tests.
(1) The strength of C.D.-4 cells - By C.D.-4 test the immunity of a person can be checked. Normally it is found between 500-1500. The high numbers of C.D.-4 cells implies high immunity & less HIV virus. Less number of C.D.-4 cells implies low immunity & high virus. If the immunity is less the chances of opportunistic infection are high. If the number of C.D.-4 cells are less than 200 & there is a presence of some serious disease like Cancer or T.B; this refers to AIDS.
Importance of C.D.-4
- The number of C.D.-4 cells can help in deciding the stage of the disease.
- The treatment & medication can be started on the basis of the number of C.D.-4 cells.
- The effect & control over the disease can be judged by checking the number of C.D.-4 cells.
- If the medication is on & still the number of C.D.-4 cells goes on decreasing, the failure of the medicine can be detected.
- The diagnosis of AIDS can be made by a number of C.D.-4 cells.
- The presence of opportunistic infection & other diseases can be judged by the number of C.D.-4 cells.
- The percentage of C.D.-4 cells can be tested by this test. This shows the strength of C.D.-4 cells out of total white blood cells. This test is not affected by the time interval between the tests. Especially in the case of children below five years, the decisions are based on the percentage of C.D.-4 cells rather than the number of C.D.-4 cells.
(2) Viral Load
Viral load means the number of virus in 1 ml of blood of HIV infected person. Generally, at the time of detection of HIV, viral load is observed to be from 50000-500000 & after six months of medication, the viral load shall be undetectable in the test but this does not mean that one is free of HIV. This only means that the viral load is below 50. Whenever the viral load goes down to 50, the test shows the result as undetectable.
(3) Complete Blood Count (CBC)
CBC is the test which is frequently carried out. Various cells like white blood cells, red blood cells & other cells are checked by this test. The hemoglobin is also checked to decide the percentage of blood. CBC report helps to detect infections, anemia & other diseases.
(4) Liver Function Test. (LFT)
This test is carried out to check the efficiency of the liver. The diseases of liver & side effects of medicines can be checked by this test.
(5) Renal Function Test. (RFT)
This shows the efficiency of the kidney. The diseases of kidney & side effects of medicines can be checked by this test.
(6) Serum Chemistry Panel.
This includes the report of blood sugar, electrolyte sodium, potassium & chlorine which can be used to check the side effects of medicines & presence of diseases.
(7) Sexually Transmitted Diseases. (STD)
This test is carried out to check the sexually transmitted diseases like syphilis, gonorrhea & chlamydia. The presence of STD increases the chances of infection of STD as well as HIV.
(8) Pep Smear
This test is carried out to check the vaginal & anal track. The vaginal & anal cancer can be judged in advance by this test. Cancer can be prevented with prior treatment. Anal & vaginal cancer is likely to occur in an HIV patient.
(9) Hepatitis ?A?, ?B? & ?C?.
Various types of Jaundice i.e. ?A?, ?B? & ?C? can be detected by the blood test.
HIV patients are found to have Jaundice also. The required treatment for Jaundice can also be decided by this test.
(10) Lipid Profile (Cholesterol & Glyceride)
The percentage of Cholesterol & Glyceride in the blood can be observed by this test. Cholesterol & Glyceride are dangerous as it is responsible for Heart & blood pressure. Some HIV medicines may increase Cholesterol & Glyceride. Hence the medicines for the same should be availed or the treatment of HIV shall be changed suitably.
(11) Blood Sugar (Diabetes)
This test is used to detect the presence of Diabetes. Some HIV medicines may increase the sugar level & medicine for this may be started.
(12) Viral Load
Viral load means the quantity of virus in 1 ml of blood. The stage of HIV is decided on the basis of viral load. Moreover, the initiation of the medicines & its effect is also decided by the viral load. Viral load & C.D.-4 cells are directly related. When viral load increases, the number of C.D.-4 cells decreases & vice versa. For the healthy human & successful treatment, the viral load should be undetectable (less than 50 in 1 ml of blood) & C.D.-4 cells should be at least 500.
Change in Viral Load.
Viral load tends to change with time. In the initial stage of infection, the viral load can be 5-10 lacs in 1 ml of blood. The C.D.-4 cells fight to protect the body & reduces the viral load. Thus for 5-8 years of infection, the viral load remains at its minimum. After that the virus increases & C.D.-4 cells decreases. At this time the opportunistic infection & other diseases are liable to happen. HIV medicines shall be started at this stage otherwise the C.D.-4 cells shall be decreased below 200 & this leads to other serious diseases like T.B. & patient suffers from AIDS.
When shall viral load be tested?
- First at the time of detection of HIV.
- At the interval of every 3-6 months.
- At the initiation of new medicine.
- Within 2-8 weeks after medications.
The reports at various intervals shall be more useful for the treatment rather than a single viral load report.
Report on viral load & initiation of medications -
Normally the initiation of medicine is decided on the basis of a number of C.D.-4 cells but in some cases, it is decided on the reports of viral load. As per the latest research, the HIV treatment should be started immediately after the detection without considering the C.D.-4 cells or viral load to decrease the damage to the immune system of a body.
Viral load & Infection -
The scientific research shows that viral load & infection are directly related. Less viral load means fewer chances of infection. However, if the viral load is undetectable, still the chances of infection cannot be ruled out as the viral load may not be detectable in laboratory test but it is present in vaginal fluid, sperms & in mother?s milk. Hence the measures to prevent infection are to be observed even if the viral load is undetectable.