What is HIV Viral Load? Let's talk about it simply

If you've been diagnosed with HIV, you've probably heard your doctor talk about 'viral load'. When he says things like, "We need to check your viral load," "Let's see if your viral load has gone down," it might sound a little complicated. What does this actually mean? Why is this test so important to your health? Don't worry, we'll explain everything in a simple way that you can understand.

What exactly is HIV Viral Load?

Simply put, HIV viral load is the amount of HIV virus in a sample of your blood. More precisely, it measures how many copies of the HIV virus's genetic material (RNA) are in one milliliter of your blood (that's about 20 drops of blood).

Think of it this way. If your body is a house, the HIV virus is like an intruder who has entered that house. The virus multiplies by making copies of itself inside the body. A high viral load means that the virus is actively spreading and making copies of itself inside the body. A low viral load means that even though the virus is present in the body, its activity and quantity are very low.

The main goal of the treatment we take for HIV infection, that is, antiretroviral therapy (ART) , is to stop the virus from multiplying in the body and bring the viral load to a level that is so low that it cannot even be detected by tests, that is, to an "undetectable" level.

What does this viral load test look for?

If you have HIV, your doctor will use this viral load test for several reasons. It's like a gauge on the dashboard of a car. Just like it tells you how the engine is working, this test can tell you a lot about the health of your body and the success of your treatment.

• See how well your treatment is working: This is the most important thing. Once you start ART, your viral load should gradually decrease. This is how your doctor can make sure that the medication you're taking is working.
• Make treatment decisions: Imagine that your viral load is staying the same or increasing again. This means that your current medication is not working properly, or the virus may have become resistant to the medication. Your doctor may then change your medication.
• Test babies born to HIV-infected mothers: When a mother with HIV gives birth to a baby, this test is used to detect at the earliest stage whether the baby is infected.
• Confirm an early infection: Sometimes, in the first few weeks after someone is infected with HIV, other tests may not be able to accurately detect it. But a viral load test can confirm it.
• Make sure you're taking your medication correctly: If you don't take your medication on time and correctly, your viral load can increase again. So this test is a reminder to you and your doctor about the importance of taking your medication correctly.

When is the viral load test done?

Usually, your doctor will do this test when you are first diagnosed with HIV. It will tell you your starting viral load. Then, you will get tested again about two to three months after you start ART. That's when they will see if the treatment is working.

After that, if everything is going well, your doctor will recommend that you have this test every three to six months . However, this schedule may vary depending on your health. Along with this test, you will also be asked to do a test called a CD4 cell count, which measures the strength of your immune system.

How is the test done?

This is a very simple blood test. A sample of your blood is taken and sent to a lab and tested using a special technique called a nucleic acid amplification test (NAAT) .

This method allows for very accurate measurement of viral load.

What happens before and during the test?

You don't need to do any special preparation for this. You can eat and drink normally, take your daily medications, and go to the test.

At the lab, a nurse or technician will use a small needle to take a blood sample from a vein in your arm. You may feel a slight stinging sensation when the needle is inserted and removed, but it only lasts a few seconds. The blood sample is then sent for testing.

The risks of having blood drawn are very low, but in rare cases, the following can happen:

• Feeling like a slob
• A bruise that turns blue and looks like a blood clot (hematoma) at the site of the sting
• Infection (this happens very rarely)
• Bleeding continues.

What do the values ​​in the test report mean?

Your results will be reported in "copies/mL." This is how many copies of the virus are in a milliliter of blood. This value can range from as low as 20 copies/mL to as high as 100,000 copies/mL.

But the important thing here is not to look at a single value, but to see whether your value is decreasing or increasing over time. If your viral load is decreasing, it means that your ART is working well. If it is increasing, your doctor will need to rethink your treatment regimen.

Let's explain these values ​​a little more in the table below.

Does "undetectable" mean HIV is cured?

Therefore, even if you reach an undetectable level, it is essential to take your medication as prescribed by your doctor for the rest of your life. Being undetectable means that your medication is working properly, you are in good health, and you cannot transmit HIV to another person through sex.

What do you do when you receive the report and if there are any problems?

It usually takes a week or two for the report to arrive. Ask your doctor when you will receive the report and how you can find out. When you receive the report, be sure to talk to your doctor about the values ​​in it. He or she will explain what they mean and your future treatment plan.

If there are signs of infection, such as pain, swelling, or pus at the site of the blood draw, go to the Emergency Department (ETU) immediately.

If my partner's viral load is undetectable, should I take PrEP?

This is a very important question. PrEP (Pre-exposure prophylaxis) is a medication that a person who is not infected with HIV can take in advance to prevent infection.

If your partner is HIV-positive, and their viral load has been consistently undetectable for at least 6 months, and they are taking their medication correctly, you are not at risk of sexually transmitting HIV.

However, if his viral load is sometimes above undetectable levels, or if he sometimes misses his medication, it is safest for you to take PrEP. This is a decision that should be discussed between you and your doctor. He or she will give you the best advice for your situation.

HIV viral load is a measure of how active HIV is in your body. This test is an important tool that helps your doctor monitor your health and the success of your treatment. If one medication doesn't work, there are many other treatments that can help bring your viral load down. So never give up hope.

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