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The results of a viral load test help determine when a CD4 count is indicated. [1] CD4 cells are the primary target of HIV. A CD4 test quantifies Helper T cells and is often combined with viral load testing to monitor the progression of HIV. CD4 testing shows the strength of the immune system, but does not report viral activity.
Viral load is reported as copies of HIV RNA in a millilitre (mL) of blood. Changes in viral load are usually reported as a log change (in powers of 10). For example, a three log increase in viral load (3 log10) is an increase of 10 3 or 1,000 times the previously reported level, while a drop from 500,000 to 500 copies would be a three-log-drop ...
Nucleic-acid-based tests amplify and detect one or more of several target sequences located in specific HIV genes, such as HIV-I GAG, HIV-II GAG, HIV-env, or the HIV-pol. [33] [34] Since these tests are relatively expensive, the blood is screened by first pooling some 8–24 samples and testing these together; if the pool tests positive, each ...
In general, a second specimen should be collected more than a month later and retested for persons with indeterminate western blot results. Although much less commonly available, nucleic acid testing (e.g., viral RNA or proviral DNA amplification method) can also help diagnosis in certain situations. [116]
The virus RNA can be detected in the blood 1–2 weeks after exposure. For a quantitative test, a low viral load is any value below <800,000 IU/L and anything above 800,000 IU/L is considered a high viral load. Lower viral loads at the start of treatment have been associated with greater likelihood to clear the infection. [15]
Suppressing the viral load to undetectable levels (<50 copies per ml) is the primary goal of ART. [56] This should happen by 24 weeks after starting combination therapy. [83] Viral load monitoring is the most important predictor of response to treatment with ART. [84] Lack of viral load suppression on ART is termed virologic failure.
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