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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 will remain in clinical latency, the next stage of the infection. The asymptomatic or clinical latency phase is marked by slow replication of the HIV virus, followed by steady depletion of CD4 ...
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]
Individuals who are in this phase are still infectious. During this time, CD4 + CD45RO + T cells carry most of the proviral load. [8] A small percentage of HIV-1 infected individuals retain high levels of CD4+ T-cells without antiretroviral therapy. However, most have detectable viral loads and will eventually progress to AIDS without treatment.
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.
Viral load testing provides more information about the efficacy for therapy than CD4 counts. [22] For the first 2 years of HIV therapy, CD4 counts may be done every 3–6 months. [22] If a patient's viral load becomes undetectable after 2 years then CD4 counts might not be needed if they are consistently above 500/mm 3. [22]
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The CD4 T-cell count is not an HIV test, but rather a procedure where the number of CD4 T-cells in the blood is determined. 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.
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] After the diagnosis of AIDS, if treatment is not available, survival ranges between 6 and 19 months.
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