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HIV Viral Load

There are many tools that your health care provider may use to assess your HIV status at the time of diagnosis. These same tools can be utilized over time to look at the progression of the disease or -- hopefully -- its lack of progression.

One of these tools is called a viral load. The viral load is the indication of the concentration of the HIV antigen. The cellular amount of virus of HIV within the body is an important indicator of the viral disease process. When HIV has replicated itself over and over again, the particle amount can be in the numerical number of billions. The viral load can be explained as a concentration amount. Let's give an example. If one takes a sip from a cup of coffee what one's taste buds would detect is obviously coffee. However if one takes a cup of coffee and dilutes that cup of coffee into a large pool that contains gallons of water and then takes a sip of that solution, the solution then would taste like water! Yet is the coffee that was diluted still part of the water? The answer is yes. However it is not detectable because it has been displaced and diluted by the water. This example is analogous to what happens with viral load. The viral antigen can be detected when it is in a concentrated amount. However, when it is diluted by the body's defense mechanism initially and by medical intervention the viral concentration (viral load) becomes non-detectable, yet it is still present. As the HIV disease persists and replication occurs and attaches to the CD4 cells, eventual destruction of these cells takes place. This then increases the amount of viral load in the blood.

Monitoring the viral load can help your health care provider decide whether treatment is indicated or whether the disease is responding to the prescribed form of therapy. This along with other parameters such as your CD4 count, the CD4 ratio, CD4 percent and your physical condition clues your health care provider to the status of the disease process.

At this time because of the newness of the protease inhibitors and the viral load monitoring measurements, questions remain about when treatment should be initiated. One theory is that treatment should be maintained so that no viral load is detectable. Yet another theory suggests that treatment should not begin (providing that the T-cells are stable) until the viral load quantifies over 5,000 to 10,000 per cc. This allows the patient less time and less of an opportunity to develop a resistance to the HIV drugs.

At the present time the viral load test is considered non-detectable when less than 400 copies of viral load are found. Newer types of viral load such as the ultra sensitive viral load test will be able to detect copies of HIV to the amount of 25 to 30 copies. At this time these important breakthroughs are thought to be very promising in the treatment of HIV and stopping the progression of the disease. Also it can detect when resistance to medical intervention is occurring prior to clinical symptoms.

It is important to your well being that these same type of tests and the same laboratory is used in estimating viral load determinations. Much like T-cells, viral load is a number and should not be interpreted solely as a clinical indicator of the present health status. Viral load can be manipulated through medication and hopefully kept at a low amount for a very long time. Should you even suspect you have HIV or another STD (sexually transmitted disease) please see your health care provider promptly.

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