The lab


One of the things I’ve had to learn as an HIV-positive person is how to understand the various blood tests that are a routine part of life with HIV. Even more difficult can be learning how to take less-than-ideal bloodwork results in your stride. It’s important to monitor your health, but I reckon it’s equally important to remember that you are not your numbers.

On this page you’ll find a summary of my most recent bloodwork, and a graph that shows you the big picture over the years since my diagnosis. On other pages you’ll find the story of Iris and my Poz FAQ.

In summary

Most recent bloodwork:
I get bloodwork done every three months, more or less. My next test is
CD4 count: The CD4 (T-cell) count is an indicator of my immune function — the higher the better (lower CD4 counts mean a greater likelihood of getting opportunistic illnesses). Ideally I want more than 500 T-cells, but anything above about 300 is pretty much OK and things don’t get serious unless they drop below about 100.
Viral load: The viral load test measures the amount of HIV circulating in my bloodstream — the lower the better. Ideally it should be ‘undetectable’, which means that the test that was used wasn’t able to find any virus at all. Viral load is the best measure of how well my medications are working.
Medications: etravirine, FTC, tenofovir. I changed my combination in early 2009, after more than nine years on the same combination (efavirenz, 3TC and abacavir). As well as taking these drugs for HIV, I take several others to prevent opportunistic infections and control other health problems. In total I take pills per day.
I’ve been taking medication to control my HIV infection almost continuously since 1991-08-06; in that time I estimate that I’ve taken about pills.
CD4 nadir: 140 The nadir is the lowest point my CD4 count ever reached. A very low CD4 nadir can make it harder to restore the immune system over time. 140′s a little low but not too bad.
Weight: kg
Avoiding weight loss is important for people with HIV – losing weight is often the first sign that something’s amiss. Weight loss can be caused by HIV infection directly, by opportunistic infections or as a side-effect of medications. My lowest-ever weight was 57kg.
The Body Mass Index (BMI) is a way of calculating whether I’m overweight or underweight for my height and body type. It should be between 20 and 25, but I’m happy for it to go a little higher.
ALT: Alanine transaminase (ALT) is a liver enzyme. High levels of ALT in the blood can indicate that my liver is unwell, possibly because of hepatitis or as a side effect of the medications I’m taking. Ideally, my ALT level should be under 47, but it rarely is.

If you’d like more information about the kinds of blood tests that positive people have, what they mean and how to make sense of them, the Australasian Society for HIV Medicine has a good PDF fact sheet (which I wrote!) that you can download.

The graph

A graph is probably the best way to show the longer-term trends in my bloodwork, which are more important than individual sets of results.