Viral load monitoring for HIV

Viral load monitoring for HIV is the regular measurement of the viral load of individual HIV-positive people as part of their personal plan for treatment of HIV/AIDS. A count of the viral load is routine before the start of HIV treatment.

Various viral load tests might be used. One way to classify tests is by whether it is a nucleic acid test or non-nucleic acid test. Variation in cost and the time it takes to get a result may be factors in selecting the type of test used.

Viral load monitoring is used by HIV-positive people to develop a plan for their personal treatment of HIV/AIDS.

A count of the viral load is routine before the start of HIV treatment. If the treatment is not changed, then viral load is monitored with testing every 3–4 months to confirm a stable low viral load. Patients who are medical stable and who have low viral load for two years may get viral load counts every 6 months instead of 3. If a viral load count is not stable or sufficiently low, then that might be a reason to modify the HIV treatment. If HIV treatment is changed, then the viral load should be tested 2–8 weeks later.

Viral load is used to predict how long an individual will remain healthy, or how quickly the disease will progress. A viral load greater than 100,000 copies/mL of blood within six months of seroconversion indicates a greater likelihood of developing AIDS within five years. A viral load less than 10,000 copies/mL of blood in the early stages indicates a decreased risk of developing AIDS.

Treatment guidelines recommend that anyone with a viral load greater than 100,000 copies/mL of blood should begin treatment. HIV is a retrovirus, an RNA virus that enters a host cell and uses the host DNA replication machinery and the enzyme reverse transcriptase to produce DNA from the viral RNA genome. HIV also produces an integrase enzyme which is used to integrate the newly produced viral DNA into the host’s DNA. The virus is then replicated every time the host cell's DNA replicates. Due to the nature of the virus the drugs used to treat HIV are called antiretroviral medicines, and the course of treatment is called antiretroviral therapy (ART). These potent medicines cannot cure an individual; they can however manage the virus and slow the progression of the HIV infection. Strict compliance with the prescribed ART regimen is vital to controlling the disease.

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