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Ask the Experts about Drug Resistance and Staying Undetectable
what is the virual load, and cell count? can you give the cell type(white/red blood cells) that are counted. or is it another type of body cells that are counted. please help
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Response from Dr. Sherer
The viral load measures the amount of viral particles of RNA in the blood, and is reported as 'copies per ML'. With early infection this number is often as high as one million, but ranges widely during acute infection and then steadies after 6 months at a level referred to as the viral load 'set point'. Higher set points, e.g. over 100,000 copies/ml, are associated with a higher risk of disease progression, i.e. developing AIDS, and death. Antiretroviral therapy can lower the viral load in the blood to a level lower than our ability to measure it - called an 'undetectable' viral load. A person on ART who achieves this level is still HIV+, i.e. still infectted, and still able to spread the virus, though to a lesser degree than a person with a higher viral load.
The CD4 cell count is the other main measure by which we monitor HIV disease progression. It is one type of white blood cell, a lymphocyte. With acute HIV infection there is a rapid fall in the CD4 cell count, because this cell is one of the principal targets of HIV. With chronic infection with HIV, an average 100 CD4 cells are lost per year. A normal CD4 cell count is 800-1200; when a person's CD4 cell count falls below 200, most of the serious opportunistic infections that are associated with HIV can occur. Hence we treat people living with HIV, if possible, before their CD4 cells fall to this level or below. Also, we measure both the total number of CD4 cells and the percent of CD4 cells (compared to all lymphocytes), because the number may rise and fall due to other effects on the total lymphocyte population.
I suggest that you talk to your doctor about these questions.
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