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A 2010 review study by Puren et al. [2] categorizes viral load testing into three types: (1) nucleic acid amplification based tests (NATs or NAATs) commercially available in the United States with Food and Drug Administration (FDA) approval, or on the market in the European Economic Area (EEA) with the CE marking; (2) "Home–brew" or in-house NATs; (3) non-nucleic acid-based test.
In the past nucleic acid tests have mainly been used as a secondary test to confirm positive serological results. [3] However, as they become cheaper and more automated, they are increasingly becoming the primary tool for diagnostics and can also be use for monitoring of treatment of viral infected individuals t.
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] Patients who are medically stable and who have low viral load for two years may get viral load counts every 6 months instead of 3. [1]
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. [32] [33] 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 ...
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. Levels higher than 200 copies per ml is considered virologic failure, and should prompt further testing for potential viral resistance. [7]
Viral load assays usually count the number of viral genomes present rather than the number of particles and use methods similar to PCR. [57] Viral load tests are an important in the control of infections by HIV. [58] This versatile method can be used for plant viruses. [59] [60]
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[3] [4] [5] RATs were more sensitive when samples had more viral load, as measured by a low PCR "cycle threshold," and less sensitive when the samples had less viral load. [ 3 ] [ 4 ] [ 5 ] A 2022 study followed 225 adults and children with COVID-19 over 15 days using PCR tests, viral cultures, and home RATs. [ 29 ]
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