It's normal to feel overwhelmed when you find out you're HIV positive. But your doctor will often talk about this `(HIV Viral Load)`. So, you probably have a lot of questions about what `(HIV Viral Load)` is, what it means, and why it's tested. Don't worry, let's talk about all this simply and clearly.
What is HIV Viral Load? What does it really mean?
Simply put, HIV viral load is a measure of how much HIV (Human Immunodeficiency Virus) is in your blood. More precisely, it is the amount of virus that can be detected in a blood test. Your doctor uses this test to see how well your antiretroviral therapy (ART) is working.
Now look, HIV is a lifelong viral infection that weakens our immune system, reducing our ability to fight disease. So, a high viral load means that the virus is very active in your body and making more copies. That means that the disease may be a little severe. But, a low viral load means that the amount of virus in your blood is very small. What we all hope for, what doctors are trying to do is to use these `(ART)` drugs to reduce the virus to a level that is not even detectable by current tests, that is, to an "undetectable" level.
What are viral load tests used for?
If you have HIV, doctors use these viral load values for several reasons:
- Monitor the effectiveness of your antiretroviral therapy (ART) . This is important to understand whether the medication is working or if you need to make a change.
- This value helps your doctor make treatment decisions . It may even change the type or dosage of your medication.
- This test is used to detect HIV infection in babies born to HIV-infected mothers at an early stage .
- It is also sometimes used to confirm early HIV infection . Although there are other tests that can usually detect HIV, you may have recently:
- If there was a high risk of exposure to HIV.
- If there is a possibility of exposure to HIV and you are showing symptoms of HIV .
- This also helps you monitor whether you are taking your medication exactly as prescribed , because only when you take your medication correctly will your viral load decrease.
Imagine, your friend Sumit has HIV. If he takes his medication (ART) as prescribed by the doctor, his viral load will gradually decrease. That means the medication is working! But if he skips taking his medication, his viral load can increase again. That's why this test is important.
When is this viral load test done?
When you are first diagnosed with HIV, your doctor will do this viral load test. Then, to see how you are responding to your treatment, your viral load will be monitored along with your CD4 count (a type of immune cell). These values can tell your doctor how well your medication is working and whether any changes need to be made to your treatment plan.
Typically, you will have a viral load test two to three months after starting ART. After that, you will need to have this test repeated every three to six months . Over time, your doctor may adjust this schedule based on your condition.
How does the HIV Viral Load test work?
In the lab, a technician will test a sample of your blood to determine your HIV viral load. A special test called a Nucleic Acid Amplification Test (NAAT) is used to determine the amount of HIV genetic material (RNA) in your blood. Think of a NAAT as a magnifying glass for viruses. It can detect even very small amounts of the virus.
Do I need to prepare anything before the test?
No, you don't need to do anything special to prepare for this viral load test. You can eat and take your medications as normal.
What should you expect when taking the test?
A doctor or nurse will use a small needle to take a blood sample from a vein in your arm. You may feel some pain or discomfort when the needle is inserted and removed. It only lasts a few seconds. The blood sample is then sent to a lab for testing.
Are there any risks with this HIV viral load test?
The risks of this viral load test are very low. Sometimes, it can be a little difficult if you have to prick the needle more than once to find a vein. Other than that, here are some of the minor risks that can occur when taking blood:
- Feeling faint, or like you're about to lose consciousness.
- It is okay to have a large bruise, a collection of blood under the skin (`(Hematoma)`).
- Infection (this is very rare).
- Persistent bleeding (this is also very rare).
Don't be afraid of these things, because they don't happen very often.
What are the results of the viral load test?
Doctors report viral load as the number of copies of HIV RNA per milliliter of plasma (the liquid part of your blood). This is usually written as either (copies/mL) or (units/mL) with the appropriate number.
Results can range from less than 20 copies/mL to more than 100,000 copies/mL. However, what’s more important than a single number is how your results change over time. If your viral load is going down , it means your ART is working well. If your viral load is going up , your doctor may need to change your medication.
You may also get a "Negative" result . This means that the test could not detect HIV `(RNA)`. This is what we call "Undetectable".
Is there a "normal" viral load for HIV?
There is no such thing as a "normal" HIV viral load. The important thing is that your levels decrease over time. The best thing is that your viral load goes down to an "undetectable" level (between 20 and 50 copies/mL, depending on the lab).
"Undetectable" does not mean you are cured – you may still be "positive" if you take other HIV tests. This is because HIV can lie dormant in your cells and can become active again when you stop taking ART. Being "undetectable" means you have a very low viral load, which means your ART is working well. As long as the HIV in your blood is at an "undetectable" level, and your ART continues to work properly, you cannot pass HIV to someone else through sex. This is very important!
What does a viral load of 200 mean?
If your viral load is below 200, it is called "viral suppression." This means that you have very low levels of HIV in your blood. Studies show that if your viral load is consistently below 200 copies/mL, your chances of getting HIV from someone you have sex with are almost zero. In the past, anything below 200 copies/mL was considered "undetectable." But new, more sensitive tests can detect even lower levels of HIV—between 20 and 50 copies/mL. So now "undetectable" means something like that.
How long does it take to know the results?
Ask your doctor when to expect your viral load test results and how you will receive them. It usually takes about a week or two to get the results.
When should I contact my doctor?
If you have any questions about your test results, contact your doctor. Also, if you have signs of infection – for example, pain, swelling, pus, fever – go to the hospital right away.
Do I need PrEP if my partner's viral load is controlled?
If you don't have HIV and your partner has HIV, it's safest to take PrEP (Pre-Exposure Prophylaxis) . It's especially important to take PrEP if your partner's viral load is sometimes "detectable" or if they sometimes skip ART doses.
However, if his HIV level remains "undetectable" and he is taking his ART correctly, without missing doses, you may consider not taking PrEP. However, your partner should continue to take his ART correctly and have his viral load checked regularly. Talk to your doctor about the best way to reduce your risk of HIV transmission.
Remember, the concept of "Undetectable = Untransmittable" (U=U) is now universally accepted. This means that if a person with HIV has an undetectable viral load, they cannot transmit HIV through sexual contact. This is a great relief for people living with HIV and their loved ones.
The most important thing to remember from what we have discussed (Take-Home Message)
HIV viral load is a measure of how active HIV is in your body. Viral load tests are a good way for your doctor to monitor your health and the effectiveness of the medications you are taking.
There are currently many different types of antiretroviral therapy (ART). If your medication is not working as well as you would like, or if it stops working after a while, there may be other options to get your viral load under control again. Never give up hope.
Make sure you understand what your viral load results mean and how they affect your treatment plan. It's important to be informed about your health and work with your doctor.
` HIV, viral load, ART, antiretroviral therapy, HIV testing, undetectable, Undetectable, U=U
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