HIV treatment guidelines have traditionally recommended that people receiving antiretroviral therapy (ART) should have their viral load and CD4 count monitored typically every three months. Less frequent monitoring could reduce cost and improve quality of life by requiring fewer medical appointments but, conversely, there was concern that adherence could decline and virological failure or toxicities could continue longer before they are detected. A new study has shown that people with HIV with suppressed viral load who have their viral load and CD4 cell count monitored every six months were no more likely to experience virological failure or to change their antiretroviral regimens than those monitored more frequently.
For people with HIV who are on a stable ART regimen and have had a suppressed viral load and a high CD4 count for some time, less frequent monitoring is a viable option. Some clinics in the UK are discussing such options with patients who are in this position. For such patients, the main issue of interest is the viral load; it can be argued that CD4 measurements (providing the CD4 count is already high) need only be done annually. All such changes to monitoring, though, should only be done after discussion and agreement between clinician and patient.
The full article can be read here.