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Viral load monitoring is used by HIV-positive people to develop a plan for their personal treatment of HIV/AIDS. [1] A count of the viral load is routine before the start of HIV treatment. [1] If the treatment is not changed, then viral load is monitored with testing every 3–4 months to confirm a stable low viral load. [1]
At this point, seroconversion, the development of antibodies, occurs and the CD4 T cell counts begin to recover as the immune system attempts to fight the virus, marking the HIV set point. The higher the viral load at the set point, the faster the virus will progress to AIDS; the lower the viral load at the set point, the longer the patient ...
A CD4 count does not check for the presence of HIV. It is used to monitor immune system function in HIV-positive people. Declining CD4 T-cell counts are considered to be a marker of progression of HIV infection. A normal CD4 count can range from 500 cells/mm3 to 1000 cells/mm3. In HIV-positive people, AIDS is officially diagnosed when the count ...
It has inspired research into other methods to try to block CCR5 expression through gene therapy. A procedure zinc-finger nuclease-based gene knockout has been used in a Phase I trial of 12 humans and led to an increase in CD4 count and decrease in their viral load while off antiretroviral treatment. [133] Attempt to reproduce this failed in 2016.
HIV can infect a variety of immune cells such as CD4 + T cells, macrophages, and microglial cells. HIV-1 entry to macrophages and CD4 + T cells is mediated through interaction of the virion envelope glycoproteins (gp120) with the CD4 molecule on the target cells' membrane and also with chemokine co-receptors. [26] [44]
After the institution of antiretroviral treatment, basically three aspects of the evolution can characterize failure or therapeutic success: the evolution of viral load, T-CD4 + lymphocyte count and the occurrence of clinical events. The progressive decline in T-CD4 + lymphocyte counts is characterized by immunologic failure.
Prognosis varies between people, and both the CD4 count and viral load are useful for predicted outcomes. [32] Without treatment, average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype. [ 6 ]
Long-term nonprogressors typically have viral loads under 10,000 copies /mL blood, [3] do not take antiretrovirals, and have CD4+ counts within the normal range. [4] Most people with HIV not on medication have viral loads which are much higher. It is estimated that around 1 in 500 people with HIV are long-term nonprogressors. [5]