State Laboratory Reporting Laws: Viral Load and CD4 Requirements
Viral load and CD4 data among persons who are HIV-infected are useful as indicators of program effectiveness. Viral load measures the amount of virus in a patient’s blood. CD4 results provide a measure of a person’s immune function and are used for determining the stage of HIV infection. Among people with HIV, measurement of CD4 results is often used to monitor disease progression and time clinical care, and both viral load and CD4 data are used to assess response to treatment. Current HIV clinical management guidelines call for CD4 and viral load testing at the time of diagnoses and every 3 to 6 months thereafter. When all values of CD4 results are reported (not just when the CD4 value indicates HIV Stage 3 [AIDS]), public health agencies can use the CD4 data as a marker for a care visit, and thus better gauge access to and maintenance in care.
While all states in the United States have enacted laws or regulations requiring laboratory reporting, not all of the laws require reporting of all CD4 and viral load results. Currently, 32 states plus D.C. have enacted laws or regulations to require laboratory reporting of all levels of CD4 and both detectable and undetectable viral loads of all HIV-positive individuals (click here to find out about specific states). For more information concerning the importance of CD4 and Viral Load reporting, see Using Viral Load Data to Monitor HIV Burden and Treatment Outcomes in the United States.