There is life with HIV

What is viral load?

What is HIV viral load?

Yes, what is the viral load of HIV is a question asked these days, with such a frenzy that it even amazes me. I heard that “today, you can be undetectable” !.

Yes it's true. Today you can keep your viral load undetectable! But in May 1997 I was, yes, I was, with the viral load undetectable!

That's not news! let me stretch the reasoning, try to follow us!

The viral load of HIV is a measure of the amount of HIV that circulates in your blood if you are HIV positive. The viral load it is used to determine how effectively your antiretroviral drugs are working and can even tell doctors when your treatment is failing or you are not taking your drugs as prescribed.

Antiretroviral Therapy Goals

The goal of HIV therapy is to prevent HIV from reproducing, with the goal of reducing the viral population (viral load) to an undetectable level. The undetectable level and copies of HIV viral RNA does not imply that there is no HIV IN YOUR BLOOD CHAIN!

Not even that the virus has been completely removed from your body; it simply means that no virus can be detected using test technologies available today. Once ART is stopped, the virus will invariably replicate itself (reproduce more and better than rabbits) and begin to replicate again.

It is important to note that the HIV viral load may vary when testing blood or other body fluids. 

For example, an undetectable viral load in the blood does not necessarily mean that you are undetectable in the semen. 

This phenomenon, known as viral shedding,it can increase the risk of transmission from people who would otherwise be considered virus free.

Life With HIV Can Be Good

People with uncontrolled viral loads are at risk of serious damage to their immune system, some of them even irreversible! And this damage can make your body extremely venerable to a growing series of opportunistic infections, many of them fatal, or with consequences that I, Claudio, would rather face with death than live as I came to see some people live. It is me speaking for myself, of my personal preferences, thus the fact that I love life as few people could understand, always keeping in mind what Rubem Fonseca said:

´ ”Life is an aesthetic entity”!

How are viral load tests performed?

Your doctor will usually draw once every three to six months to measure your viral load. Viral load tests quantitative younger and ultra-sensitive ones can detect viral activity as low as five copies / mL to well over 1.000.000 copies per milliliter (copies / mL).

In contrast, the tests qualitative HIV viral load are simply used to confirm the presence of HIV and are commonly used to test babies and newborns born to HIV-positive mothers.

The test involves a simple blood collection that requires 6 mL of blood (approximately one and one teaspoon). You need to fast or avoid medications before the blood is drawn.

Interpreting the Results

The goal of testing for viral load is simple: the fewer copies of HIV in the blood, the better. When starting treatment, viral load tests provide the baseline measurements against which subsequent tests are compared.

Each ten-fold drop in viral load is considered a fall in a trunk. For example, if the viral load drops from 50.000 copies / mL to 500 copies / mL, the patient is said to have a two-pronged drop in viral load.

In general, with the current generation of HIV drugs, one can expect to have an undetectable viral load anywhere between two to nine months after starting ART. 

Although the speed at which suppression is achieved can vary, it tends to be slower in people who have delayed the START of treatment and suffered severe immune damage.

We measure this by counting CD4 of a person who quantifies how many defensive CD4 T cells remain in the blood. A person with normal immune function may have between 500 and 1.500 cells / mL, while people with a compromised immune system will have less than 300 cells / mL.

In addition, if a person has developed or acquired resistance to any of the prescription drugs, the likelihood of viral suppression can also be severely compromised. In that case, treatment will need to be changed after genetic testing (genotyping) reveals which drug or drugs the patient is resistant to.

Benefits of Viral Suppression

The goal of HIV therapy is to sustain undetectable viral loads for many years, which not only preserve future treatment options, but reduce the risk of serious illness by 53% (according to a 2011 study in the New England Journal of Medicine).

In addition, sustaining an undetectable viral significantly reduces your chance of passing the virus on to others, a prevention strategy known as treatment as prevention (TasP).

Current research have shown that having and maintaining an undetectable viral load eliminates the risk of transmitting HIV to an uninfected partner, whether for anal, vaginal and oral sex.

Remember: As frightening as your first result in a viral load test may be, all you have to do is keep your treatment and regularity under Spartan discipline, draconian control and Teutonic fist.

There is no virus that can subvert the human will and determination to win and live!

There is life with HIV

Translated by Cláudio Souza do Original in What Is HIV Viral Load and Why Is It Important?

Rodger, A .; Cambiano, V .; Bruun, T. et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet. 2019 May 2; pii: S0140-6736 (19) 30418-0. It hurts:10.1016/S0140-6736(19)30418-0

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