When you’re living with HIV, there are a few health markers that your doctor will use to keep track of your care. One of them is your viral load. These numbers are an essential part of your treatment, so you need to know what’s expected and what’s not.
What Your HIV Viral Load Should Be
First, it’s helpful to know what the HIV viral load is. It’s defined as the amount of human immunodeficiency virus (HIV) that a test can detect in your blood. Since HIV is a lifelong illness, the virus remains in your body and continues to compromise your immune system. As it replicates, the viral load rises. However, if your antiretroviral therapy is effective, the virus isn’t as successful at replicating, so you’ll have a low viral load, which is the aim of treatment.
While no set number is considered to be a normal HIV viral load, there are a few ranges that you should know. If your level falls below 200 copies per mL, then doctors consider that to be viral suppression. At this level, your treatment is going well, and you’re less likely to spread the virus through sex. If it falls to 20 – 50 copies per mL, then that is called the undetectable level. Although hitting that range doesn’t mean you’ve been cured, it’s a strong indicator that your antiretroviral therapy is effective.
You May Also Like
You should also know that reaching an undetectable level with your HIV viral load doesn’t mean your doctor will stop checking. Regardless of your results, there will still be a testing schedule so your doctor can continue to confirm that your treatment is working.
How They Relate to Your Treatment
The first time your HIV viral load should be tested is within two to eight weeks of being diagnosed. At this point, your doctor can use those results to stage your HIV infection. The numbers may vary, but a viral load in the hundreds could mean you’re in the early stages. That can increase to thousands for the second stage or chronic HIV infection. Although it’s rare for people to get to the third and advanced level of infection, someone at that stage may have a viral load in the millions.
Once your doctor knows what your viral load is, though, they can determine which combination of antiretroviral drugs to start with. Even then, you will be tested every three to four months as your treatment continues. Generally, your viral load should start to go down within six months of antiretroviral therapy.
You May Also Like
This is a blood test to measure the amount of HIV in your blood. HIV causes AIDS. This test should be done two to eight weeks after you’re diagnosed with HIV and then every three to four months during long-term therapy. If your treatment is effective, your viral load should go down in four to six months. That’s why your doctor will keep checking your viral load. Even if your viral load is going down, your doctor will determine the best testing schedule to monitor your treatment.
Sometimes, your medication isn’t effective or stops working. Your viral load is the fastest way for your doctor to know that it’s time to adjust your treatment.
RELATED: Key Nutritional Supplements for Those Living with HIV
Top Signs That Your Treatment Isn’t Effective
Despite the number of studies done to establish how often antiretroviral treatment isn’t effective, the range is significant. Researchers suggest that more studies need to be done, but the difference in numbers may be attributable to the type of medication being used as well as the standard being used to measure success.
For example, the suppression of the immune system may fail at 13.2 percent, while there may be a 14.7 percent failure when it comes to the suppression of HIV RNA. One study showed that antiretroviral therapy failed at a rate of 20.3 percent. When all the studies conducted between 2007 and 2022 were considered, however, the rate rose to as high as 42.65 percent.
Regardless of what the studies say, monitoring your HIV viral loads will help your doctor to see if your treatment is no longer effective. You may also be able to tell that something is wrong if you know what signs to look out for. Some symptoms you may notice with ineffective treatment are an unexplained fever, chills, persistent joint pain, chronic fatigue, a sore throat, muscle aches, regular headaches, and swollen lymph nodes.
While the symptoms may initially resemble the flu, it’s crucial to inform your doctor about them. The sooner you test your viral load, the quicker they can decide on the course of action.
RELATED: 10 Steps to Live Longer with HIV/AIDS
What Your Doctor Will Likely Do About It
As your doctor is working to determine the best alternative antiretroviral therapy for you, they will also want to find out why the drugs stopped working. One of the most common reasons drugs become ineffective is that you develop a resistance to them. This resistance can happen because of changes in the genetic structure of the virus, the emergence of drug-resistant HIV strains, having previous exposure to antiretroviral therapy, being born to a parent who has HIV, and not taking your medication as prescribed.
The good news is that there are resistance tests that can let your doctor know if you’ve developed a drug-resistant strain of the virus. If you do, then they can prescribe drugs that have the highest chance of controlling the virus.
If you haven’t been taking your medication as prescribed, you need to be honest with your doctor about it. Some people stop taking their medications because of the side effects, which can vary in severity. Although this is an understandable concern, it’s best to discuss what’s happening with your doctor so they can suggest ways to manage the side effects. If your reasons are financial, then your doctor may be able to help with that as well.
Your treatment may also stop working if your dose isn’t adequate, there are interactions with other drugs, or you’re having trouble absorbing the medication. These aren’t as likely, but your doctor can still modify your medication to account for them.
Knowing your viral load is an important part of your treatment. Once you’ve been tested after your initial diagnosis, your doctor will let you know what your testing schedule will be. Doing so will help your doctor monitor your care. Even though your doctor is tracking your viral load, you should let your doctor know if you have any symptoms that suggest your treatment is failing.
