Early and late diagnosis

Early diagnosis and primary infection

Some people who discover that they are HIV-positive within six months of being infected decide to start treatment straight away. This is regardless of their CD4 count and viral load.

Using early treatment may enable you to benefit from immune treatments or vaccine-related research in the future. But, you need to balance these potential benefits, against side effects and the risk of resistance. Also, that you may not medically need treatment for many years.

Treatment in primary infection is therefore largely only provided in clinical trials.

Late HIV diagnosis and low CD4s

Some people, across all age ranges, only find out they are HIV-positive when they become ill and admitted to hospital. This often means starting treatment straight away, especially when the CD4 count is below 100 cells/mm³.

Even with a very low CD4 count, even below 10 cells/mm³, if you follow your treatment very carefully, you have a good chance that treatment will work. Your viral load will drop and your CD4 count will rise again to safer levels.

This should not be seen as a reason to delay treatment. Starting with a very low CD4 count can sometimes cause dormant infections, such as TB and CMV, to activate. This is called Immune Reconstitution Syndrome.

Tests and research trials for acute HIV infection

If you think that you were infected within the last six months, you can ask for a de-tuned (STARHS) HIV test. This test can confirm a recent infection. Your doctor can access this test free from the Health Protection Agency (HPA) HIV laboratory in Colindale (020 8200 4400).
If you are interested in a trial, you can contact the research unit at St Mary's Hospital (020 7886 6047) or the Royal Free Hospital (020 7472 6232) in London.

This is the web edition of the i-Base guide Introduction to combination therapy. This guide is available in UK clinics. You can order free printed copies or download a PDF version (513 Kb). Translations. Authors and credits. Glossary. Full section index.

Decisions relating to your treatment should always be taken in consultation with your doctor. Information in this guide is intended to support those discussions.