Human immunodeficiency virus (HIV) is among the most critical sexually transmitted infections due to its
If you’ve been diagnosed with the human immunodeficiency virus (HIV), you may be scared and confused. What exactly is an HIV viral load, and what does it have to do with your condition? What kinds of tests will you have to do?
We have collected some helpful information below to answer these questions and help you understand what your diagnosis means.
Your doctor will conduct an HIV viral load test every so often to track the virus’s progression in your body. Keep reading to learn about what this tells you and what you can do to reduce your viral load.
What Does the Viral Load Test Measure?
HIV is a virus that tests can detect in the bloodstream. Once the virus takes hold, it reproduces, increasing the number of HIV RNA (genetic material) in the blood.
HIV attacks healthy white blood cells, mainly CD4 cells, causing lowered immunity. If the virus reduces white blood cells to a very low number, a person may be diagnosed with acquired immunodeficiency syndrome (AIDS).
An HIV viral load test measures the amount of the virus’s RNA present in the blood, essentially measuring how much HIV is in your body. Physicians use it for:
- Diagnosing HIV if antibody tests are inconclusive
- Monitoring increases or decreases in HIV viral load
- Monitoring the effectiveness of current medications
If you suspect you have been exposed to HIV recently, your doctor may use this test to confirm an HIV diagnosis. If you have a diagnosis, your doctor will use it to keep track of the virus in your body and determine treatment needs.
How Do Doctors Conduct a Viral Load Test?
To test your HIV viral load, your doctor will simply need to draw your blood. You don’t need to prepare beyond alerting your doctor if you’ve had a recent illness or viral outbreak that might affect the results. For example, if you’ve had a recent herpes simplex outbreak or the flu, you should tell your doctor before taking the test.
You may experience a pinching pain when the needle goes in, but drawing a blood sample is a simple process with little risk involved. Be sure to eat something before you go in to prevent dizziness, and if you’re afraid of needles, look at something else. You may even tell the nurse a story to distract yourself.
When Should I Get Tested?
HIV viral load tests can help diagnose acute HIV, which is the earliest stage. Up to 60% of people do not experience any symptoms during this stage, but there are some symptoms to look out for:
- Swollen lymph nodes (in your throat, under your arms, etc.)
- Muscle or joint pain
- Sore throat
If you are experiencing these symptoms and believe you may have been exposed to HIV, you may benefit from HIV viral load testing.
What Do the Viral Load Test Results Mean?
The results of a viral load test provide a number that indicates how much HIV RNA is present in your blood, measured in copies per milliliter of blood. The higher the number of copies, the larger your HIV viral load.
Besides using viral load tests for initial diagnoses, doctors also use them at regular intervals during treatment to determine the effectiveness of the current medication. If viral load numbers increase during treatment, professionals know the person needs alternative treatment options.
If a viral load test produces a normal result, this indicates the person is negative for HIV.
High Viral Load
When test results provide a number at or above 100,000 copies, they indicate a high viral load. People receiving their first test may even see numbers higher than one million copies, which means the virus is actively progressing and replicating.
Low Viral Load
Professionals consider a viral load number below 10,000 copies to be low. A low viral load means the virus is progressing more slowly or that treatment efforts are working to reduce the amount of the virus in the body. HIV treatment aims to reduce these numbers further.
Undetectable Viral Load
The goal of HIV treatment is an undetectable viral load of fewer than 200 copies. Although HIV has no cure, people with undetectable viral loads have effectively suppressed the virus.
They must continue to take medication to keep the viral load down, but they likely will have relatively normal life spans and won’t infect others.
How Fast Does Your Viral Load Increase Without Meds and Treatment?
A person’s HIV viral load increases without treatment as the virus replicates and depletes white blood cell counts. Professionals track HIV progression in five stages.
The first stage, infection, sees a steady virus buildup in the lymph nodes following exposure. The second stage, seroconversion, occurs when the virus reaches the bloodstream. If left untreated, viral load can increase very quickly within a few weeks, causing symptoms in 80% of people.
The body’s own defenses often slow this initial spike in viral load, but the virus continues to progress without proper treatment. Stages three, four, and five occur consecutively as the virus replicates and time passes.
The last stage, late-stage infection, has become less common due to earlier detection and better treatments. The late-stage infection mostly occurs when a person cannot get treatment, gets a late diagnosis, or becomes resistant to antiretroviral drugs.
High Viral Load Symptoms
Especially during the second stage, when viral load increases dramatically, people may experience various symptoms of a high viral load. These symptoms include:
You may experience excessive sweating at night while you’re asleep.
You may develop fevers as your body tries to fight off the virus. Fevers can also contribute to night sweats and other symptoms.
Weakness and Tiredness
A high viral load is hard on the body, causing you to feel overly weak or tired.
Although this symptom is rarer than others, you may develop mouth ulcers, which are sores on the soft tissue inside your mouth.
When Is HIV Viral Load the Highest?
For a person who receives regular treatment, HIV viral load is the highest a few weeks after infection. The body has not yet had a chance to try to fight the virus, thus allowing it to replicate unchecked. Most people are at their most contagious during this time when the viral load is very high.
How to Reduce Viral Load
An HIV viral load becomes reduced through viral suppression therapy. Lifestyle changes won’t affect viral load, but they can prevent other infections that may challenge a compromised immune system.
Professionals use antiretroviral therapy to treat HIV. These medications stop or greatly reduce replication of the virus, which can result in a lower viral load in a relatively short time. Many people reduce their viral loads to undetectable within six months of starting treatment.
Although living a healthy lifestyle will not directly affect your viral load, you can help prevent other infections, increase your overall energy, and improve your strength through regular exercise and a balanced diet.
It’s also important to practice safe sex even with an undetectable viral load measurement to reduce the risk of other STDs. Click here to learn whether you can get multiple STDs.
Why Undetectable Viral Load Also Means Untransmittable
As stated above, an undetectable viral load indicates the virus is not transmissible. It has become dormant within the body and is no longer replicating. HIV is most infectious when the viral load is high, so the goal of HIV treatment is always to reach an undetectable level at which the person is not likely to pass on the virus.
HIV Transmission Through Sex
A person who has had an undetectable HIV viral load for at least six months and is consistently taking their medication does not need to worry about infecting any sexual partners. The virus is dormant at this point and not infectious.
However, it remains unclear if the presence of other STIs affects HIV transmission even with an undetectable viral load.
HIV Transmission Through Pregnancy and Breastfeeding
Minimal risk to the baby exists for a pregnant woman who has an undetectable HIV viral load and continues to take antiretroviral medications throughout the pregnancy and labor. Newborns also receive treatment and tests for HIV at regular intervals depending on how high the risk level is.
Although many women living with HIV are able to have healthy babies, the CDC does not recommend breastfeeding for mothers with HIV.