When To Get Tested
When first diagnosed with HIV 2 to 8 weeks after the start of therapy or therapy changes, then every 4 to 8 weeks until the viral load is not detectable then every 3 to 4 months if you are on stable therapy and the virus remains suppressed after two years of this, viral load testing frequency may be decreased to every 6 months.
Why Is Hiv Therapy So Important
HIV therapy is also called antiretroviral therapy or highly active antiretroviral therapy . It consists of a combination of antiretroviral drugs. Theyre designed to keep the virus from spreading throughout your body by targeting different proteins or mechanisms the virus uses to replicate.
Antiretroviral therapy can make the viral load so low that it cant be detected by a test. This is called an undetectable viral load . If a person is virally suppressed or has an undetectable viral load, their HIV is well managed.
Starting HIV therapy as soon as an HIV diagnosis is received helps allow a person to live a long, healthy life.
Current treatment guidelines provided by the U.S. Department of Health and Human Services recommend that a person living with HIV begin antiretroviral drugs as soon as possible after diagnosis. This is essential to reducing opportunistic infections and preventing complications from HIV.
Effective treatment can also help prevent the transmission of HIV to others. This is also known as treatment as prevention.
According to the
Why Do I Need This Test
You may need this test if you’ve had unprotected sex or shared contaminated needles and want to know whether you’ve contracted HIV. Standard antibody tests aren’t as accurate as the viral load test because they can take up to six months to show that you have HIV. In that time, it’s possible to infect someone else.
If you’re pregnant, it’s especially important to find out if you have HIV. Starting treatment right away can lower the risk of passing the virus on to your baby.
It’s also likely that you will have this test if you’ve already been diagnosed with HIV. You may have the first test 2 to 8 weeks after diagnosis and again at 4- to 6-month intervals. The findings help healthcare providers find the best medicine to get your viral load down and keep you healthy.
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How Much Does The Test Cost
The cost of HIV viral load testing depends on where a patient has the test conducted and whether they have health insurance. Additionally, laboratory and other charges vary. Patients should discuss the costs of testing with their doctor, the laboratory, and/or their health insurance provider.
If paying for HIV testing and treatment is a concern, resources are available to help people with HIV gain access to medical care through the US Department of Health and Human Services: How to Find HIV Treatment Services.
Why Is It Important To Get Tested Regularly
A single CD4 or viral load test result only represents a snapshot in time. Its important to track both of these and consider trends in test results rather than only looking at individual test results.
Keep in mind that these values may vary for many reasons. The time of day, any illnesses, and recent vaccinations can all affect CD4 count and viral load. Unless the CD4 count is very low, this fluctuation isnt usually worrisome.
Regular viral load tests, not CD4 counts, are used to determine the effectiveness of HIV therapy. The goal of HIV therapy is to reduce or suppress the viral load to an undetectable level.
According to HIV.gov, HIV viral load is typically undetectable below levels of 40 to 75 copies/mL. The exact number depends on the lab that analyzes the tests.
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How Is Viral Load Used In Hiv Treatment
The viral load is then used to monitor the effectiveness of antiretroviral treatment over time. HIV viral load testing measures the amount of HIV genetic material in the blood and reports how many copies of the virus are present.
A high viral load is generally considered about 100,000 copies, but you could have 1 million or more. The virus is at work making copies of itself, and the disease may progress quickly.
What Is The Viral Load In Hiv
Viral load is an indication of the amount of virus in the bloodstream in HIV infection. It also known as HIV viral load or plasma viral load and is an important means to monitor the progress of the disease and the success of treatment. Regularly monitoring the viral load, at least every 3 to 6 months, while on HAART is essential in the management of HIV/AIDS. The viral load is the amount of nucleic acid in the bloodstream and not the actual number of viruses.
In HIV infection, the virus injects its proteins into the CD4+ T-lymphocyte cells. The RNA is the blueprint of the virus that is used by the hosts protein-making apparatus. The proteins make up the RNA and enzymes for many more new viruses. In the viral replication process, the T-lymphocyte cell is destroyed and the number of viruses increases exponentially. CD4 count is a measure of the bodys CD4 T-lymphocyte levels and as it declines, the viral load increases. Read more on HIV and AIDS.
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What Does An Undetectable Viral Load Mean
An undetectable viral load is reported when the level drops to below 50 copies/ milliliter. This does not mean that the virus has been eradicated from the bloodstream or that the patient is cured. The viral RNA may just be below the threshold and cannot be detected. Eventually the viral load will rise again and regular monitoring even with an undetectable viral load is therefore essential. The aim of treatment is to maintain the viral load at undetectable levels as long as possible.
What You Need To Know
- A viral load test measures the number of copies of the virus in your blood. It is reported as copies/ml.
- Viral load is a sign of how active HIV is in your body. A lower number means the virus is less active.
- You will have your viral load tested regularly.
- Even low levels of HIV in the body can cause inflammation and cause damage. This is one reason why early treatment is now recommended.
- If you are taking ART and have an undetectable viral load you are significantly less likely to transmit HIV to others
- If you are taking HIV treatment, a consistent increase in your viral load may be a sign that the virus is developing resistance to one of your anti-HIV drugs. You and your doctor will discuss what to do next.
McLay D, Knowles Z
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What Is An Hiv Viral Load
An HIV viral load is a blood test that measures the amount of HIV in your blood. HIV stands for human immunodeficiency virus. HIV is a virus that attacks and destroys cells in the immune system. These cells protect your body against viruses, bacteria, and other disease-causing germs. If you lose too many immune cells, your body will have trouble fighting off infections and other diseases.
HIV is the virus that causes AIDS . HIV and AIDS are often used to describe the same disease. But most people with HIV don’t have AIDS. People with AIDS have an extremely low number of immune cells and are at risk for life-threatening illnesses, including dangerous infections, a severe type of pneumonia, and certain cancers, including Kaposi sarcoma.
If you have HIV, you can take medicines to protect your immune system, and they may prevent you from getting AIDS.
Other names: nucleic acid testing, NAT, nucleic acid amplification test, NAAT, HIV PCR, RNA Test, HIV quantification
Can An Hiv Rna Test Be Used To Screen For Hiv
The recommended test for HIV screening is a combination test that detects HIV antibody and HIV antigen. By detecting both antibody and antigen, the combination test increases the likelihood that an infection is detected soon after exposure. Most HIV screening tests detect only HIV antibody but are good options for screening because they may be available as rapid tests and at the point of care. If any of these screening tests are positive, they must be followed by another different antibody test. If the second test is positive, then HIV diagnosis is confirmed. If, however, the first and second result do not match, then an HIV RNA test may be done to help establish a diagnosis.
The recommended screening test for newborns, however, is an HIV RNA test .
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Do I Still Need To Worry About Other Sexually Transmitted Infections
Neither HIV treatment nor PrEP prevents other sexually transmitted infections, or STIs.
Ways to reduce the risk of STIs include having both partners tested, limiting the number of sexual partners and using condoms. Vaccines are available to prevent some STIs, including hepatitis B and human papillomavirus .
Preparation Prior To Transport
Label the specimen container with the patients full name, date of collection and one other unique identifier such as the patients date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.Place specimen in a biohazard bag and seal. It is recommended to ship specimens for testing to PHO Laboratory immediately after collection or processing to avoid delays in testing. Whole blood that has not been centrifuged must be received at PHO Laboratory within 24 hours of collection, before 2:00 p.m. Monday – Friday. Plasma stored at 2°C – 8°C must be shipped with ice packs within 6 days of separation. Frozen plasma must be shipped on dry ice.Shipping of specimens shall be done by TDG certified individuals in accordance with TDG regulations.
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How Do I Explain This To A Sexual Partner
If you have sexual partners who are not living with HIV, explaining U=U to them is likely to be mutually beneficial. If you had previously relied on other means of preventing HIV transmission , you may jointly decide that these methods are no longer necessary because of U=U.
It may take some time for an HIV-negative partner to accept the U=U message and to rely on it as the sole method of preventing HIV. Some HIV-negative people may reject the message or deny its accuracy. It may be helpful to direct your partner to information resources that explain the accuracy and significance of U=U. NAM has also produced a page for people who dont have HIV to help them understand the impact of an undetectable viral load on HIV transmission.
Another option could be for your partner to hear about U=U from a healthcare worker or another reliable and trusted source.
Despite sharing this information, some people may still not accept that U=U. In this kind of situation, it is important to find a balance between providing your partners with information and taking care of yourself.
Many people find it difficult to talk about sex, even with the person who is closest to them. If this is the case, you might want to discuss your concerns with someone at your HIV clinic, sexual health clinic or a support organisation. This can help you clarify your thoughts and what youd like to say.
British Hiv Association Advice
The ‘Undetectable equals Untransmittable’ campaign is supported by the British HIV Association , which is the professional association for doctors and other healthcare professionals working in HIV in the UK.
BHIVA says consistent use of HIV treatment to maintain an undetectable viral load is a highly effective way to prevent the sexual transmission of HIV.
BHIVA says healthcare professionals should share this information with all people living with HIV. It advises healthcare professionals to explain the scientific evidence behind U=U, emphasising the importance of excellent adherence to HIV treatment and highlighting that U=U is dependent on maintaining a sustained undetectable viral load.
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Cd4 Count Vs Viral Load
Theres no direct relationship between CD4 count and viral load.
In the past, doctors used the CD4 count as an indicator of when to start therapy, but advances in HIV medication have changed this. Now it serves as an indicator of immune system stability.
However, in general, a high CD4 count and a low or undetectable viral load are desirable. The higher the CD4 count, the healthier the immune system. The lower the viral load, the likelier it is that HIV therapy is working.
When HIV invades healthy CD4 cells, the virus uses them to make new copies of HIV before destroying them. When HIV remains untreated, the CD4 count decreases, and the viral load increases.
The following chart gives a general idea of what the levels of CD4 and viral load mean for a person with HIV, based on guidelines from the U.S. Department of Health and Human Services.
|How serious is this?|
|After levels remain stable for 2 years.||Up to 6 months interval|
What Is A Cd4 Count
A CD4 count is a blood test to check the amount of CD4 cells in the body. CD4 cells are a type of white blood cell. They play a key role in the immune system. They alert other immune cells to the presence of infections such as bacteria and other viruses in the body. CD4 cells are also a subset of immune cells called T cells.
When a person is living with HIV, the virus attacks the CD4 cells in their blood. This process damages CD4 cells and causes a drop in the number of them in the body, making it difficult to fight infections. Monitoring CD4 cells is important for people who are receiving treatment for HIV.
CD4 counts vary widely. For many people, however, the higher a CD4 count is when they receive a diagnosis and start treatment, the more quickly they are likely to see it rise as a result of therapy. This is one reason why an early diagnosis is essential.
The chart below summarizes the ranges of CD4 counts:
|Under 200 cells/mm3||A doctor will diagnose AIDS.|
CD4 counts show the robustness of the immune system. A healthy immune system normally has a CD4 count ranging from 500 to 1,600 cells per cubic millimeter of blood , according to HIV.gov.
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What Is This Test
This is a blood test to measure the amount of human immunodeficiency virus in your blood. HIV causes AIDS. This test should be done 2 to 8 weeks after you’re diagnosed with HIV and then every 3 to 4 months during long-term therapy. If your treatment is effective, your viral load should go down in 4 to 6 months.
Although HIV antibody testing is widely used to detect HIV, viral load testing can also diagnose the infection. Because the viral load test measures genes and chemical compounds found in HIV, it can find the virus in your blood within days of infection.
HIV antibody testing, however, may give a negative result until the virus has been in your body for 2 to 6 months. You may not show signs of HIV even if the virus is already multiplying in your blood. Because HIV has no cure, it’s important to find out as soon as possible if you have the virus so treatment can be started.
If you’re taking medicines to lower levels of the virus in your body, this test shows if the medicines are working. The more your viral load goes down, the healthier you are likely to be.
How Variable Is An Undetectable Viral Load Can This Change Over Time
HIV specialists have decades of experience managing antiretroviral therapy and are confident that you can remain uninfectious as long as you:
- take your medication every day as prescribed, and
- have your viral load checked regularly.
The presence of other sexually transmitted infections can potentially affect viral load, but in the PARTNER study there were no HIV transmissions even when other STIs were present. Those results held through the PARTNER 2 trial as well.
It is however important to remember that HIV treatment can only be successful if you have access to it and are taking it as prescribed.
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Does Hiv Treatment Always Work
About one in six people on their first HIV treatment regimen either never have an undetectable viral load or their treatment stops working in the first year. During the second year on treatment, the chance of your therapy ceasing to work is about one in twenty and this declines further over the next decade to about a one-in-fifty chance of failure in any one year.
So, the longer youve been on a particular HIV therapy, the less likely it is to stop working. Almost everyone who goes on to a second or third regimen reduces their viral load to an undetectable level.
If someones treatment does not result in viral load becoming undetectable, this is usually because they are having problems taking their treatment as prescribed, i.e. they dont take all their pills at the right time, without missing doses. Occasionally missing a dose of medication is unlikely to cause your viral load to become detectable again, but frequently missing doses may lead to a detectable viral load and should be avoided.
If you are having problems sticking with your treatment, talk to your doctor and they may be able to find a drug combination that suits you better.