Day one:
After you've tested positive

May 2008     View PDF     En español

Checking on your immune health

With most illnesses, we wait until a disease shows up before doing anything about it. “If it ain’t broke, don’t fix it.” But in HIV disease, the immune system starts to “break” immediately, not just when OIs show up. So keeping an eye on the health of your immune system is critically important. Two common ways to do this are: (1) noticing when symptoms occur and (2) getting lab tests done. Each can appear to have advantages and disadvantages.

Noticing when symptoms occur

This approach waits for active infections and disease to occur. In HIV, this means watching out for such things as thrush (yeast infections), PCP, Kaposi’s Sarcoma (KS) lesions and so on.

Advantages
It is easier to believe and take action when we are faced with an obvious illness. People who feel sick usually want to treat the illness as soon as possible.

Disadvantages
HIV disease progresses even before symptoms appear. By the time they do appear, treating the underlying problem may be less effective because your body is left with fewer defenses.

Getting lab tests done

This approach doesn’t wait for symptoms or disease to occur. This means getting routine tests done to check on the different parts of your immune system. These tests include: HIV antibody tests; CD4 cell counts; viral load tests; and basic blood tests.

Advantages
The laboratory signs of illness usually show up before you actually feel sick. Using these various test results help people and their doctors prevent serious infections before they occur. They also help them make treatment decisions based on real numbers and not just guesses.

Disadvantages
Some people find it difficult to act on their test results, since they often feel fine no matter what the lab numbers say. People who feel healthy may be less motivated to start treatment. Test results vary, and they change for many reasons.

Because HIV infection can be a life-or-death matter, it is critical to choose the second approach. Taking a preventive approach makes it possible to:

• use treatments when they’re most effective,
• prevent the most serious infections, and
• slow the rate of disease progression and permanent damage to your immune system.

Some people say they hesitate to act before they’re sick because today’s treatments are not perfect, hoping to wait for something better to come along. However, no one knows when “perfect” treatments will become available. It is well proven that today’s treatments can extend survival time. Although we can’t predict the results for every person, we do know what generally happens without treatment.

The purpose of preventive action is to slow the progress of HIV disease. This approach is the one that seems to offer the clearest hope. Once infected, you have one chance to manage your disease correctly. So consider your options carefully and learn how to tell when a therapy is or is not working for you. To learn more, read Project Inform’s publications, Making Decisions about Therapy and Blood Work: Two Common Tests to Use.