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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]
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]
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 ...
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.
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 drops below 200 cells/μL or when certain opportunistic infections occur. This use of a CD4 count as an AIDS criterion ...
Changes in viral load are usually reported as a log change (in powers of 10). For example, a three log increase in viral load (3 log10) is an increase of 10 3 or 1,000 times the previously reported level, while a drop from 500,000 to 500 copies would be a three-log-drop (also 3 log10). [citation needed]
Suppressing the viral load to undetectable levels (<50 copies per ml) is the primary goal of ART. [56] This should happen by 24 weeks after starting combination therapy. [83] 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.
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.
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