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If you've been told that you have HIV, your doctor will ask you questions about your health and do some tests to see if the virus has damaged your immune system. You may need to start taking some treatments right away.

Your doctor will ask you about your health. It helps to know what illnesses you've had in the past because some infections can come back when you have HIV.

And you'll probably have many questions for your doctor.

Your doctor will usually do two blood tests to see whether HIV has damaged your immune system.

One test measures the amount of HIV in your blood. This is called your viral load. The other test counts the number of CD4 cells in a small amount of your blood. This is called the CD4 count.

To learn more, see:

• Viral load
• CD4 count.

Your doctor may do some blood tests to check your general health. This helps your doctor choose the best treatment.

You may also have blood tests to see if you have some other infections. Some bugs may be living in your body even though you don't have the disease. For example, almost everyone with HIV is also infected with cytomegalovirus (CMV for short). If you're healthy, this bug doesn't normally cause any problems. But if your immune system is damaged by HIV, you may develop symptoms. This may happen many years after you find out you have HIV.

You'll probably also have tests for some common sexually transmitted diseases, such as syphilis, gonorrhea and chlamydia.

You may have a blood test for hepatitis C, an infection that can damage your liver. If you have hepatitis C, it's good to have it treated before your HIV needs to be treated. This is because the drugs used to treat HIV are hard on your liver. So you'll cope with HIV medications better if your liver is in good shape. That means being free of hepatitis C.

To learn more, see Hepatitis C and HIV.

If doctors know what infections you've had before, they can give you treatments to stop them from becoming active again.

You may have a special blood test called resistance testing. This looks at the HIV particles in your body to see whether the virus has become resistant to any drugs. Once a virus is resistant to a drug it means that the drug won't work. This will be important when you come to think about taking antiretroviral drugs.¹

You can be tested for a disease called tuberculosis. Tuberculosis is caused by a type of bacteria. You will have a skin test, called a ppd test, to see if you have come in contact with this type of bacteria. If your skin test shows you have (if it's positive), then you will have a chest X-ray to see if you have tuberculosis in your lungs. If you have tuberculosis, then you will be given treatment. If you have a positive skin test but a normal chest X-ray, you will be given medication to prevent tuberculosis.

HIV gradually damages your immune system, the cells that protect you against infections. So you may be advised to get one or more vaccinations to keep you from getting infections that can be difficult to beat if you have HIV.²

• Hepatitis B vaccine: This protects you against the virus that causes hepatitis B. Hepatitis B is a serious disease, which can lead to liver scarring (cirrhosis), liver cancer and death. It might cause headaches, nausea, vomiting, stomach cramps, yellow skin and tiredness. But many people don't get these symptoms. They only find out they have it after they have been diagnosed with cancer. But hepatitis B can often be treated.
• Hepatitis A vaccine: This protects you against the virus that causes hepatitis A. Hepatitis A can cause nausea, vomiting, stomach pain, yellow skin and liver damage. But most people recover fully from it without any lasting liver damage.
• Influenza vaccine: This protects you against certain flu viruses. You have to get a flu shot each year as the type of viruses around change from one year to the next.
• Pneumococcal vaccine: This protects you against a type of bacteria that can cause pneumonia and that can be difficult to beat if you have HIV.

If you have HIV, you should not have some "live" vaccines, such as BCG (against TB) and yellow fever. This is because live vaccines work by stimulating your immune system to produce protection against these infections. If your immune system is damaged, your body may not be able to mount this defense and the vaccines will either fail to work or could make you ill.³ Other live vaccines, including the one against chicken pox are usually safe, but you should discuss this with your doctor.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.