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"understanding viral load testing"
Sep 4, 1996

I am interested in finding out what a base line number or "norm" is for the viral load testing. A friends brother gave her the results of a recent test and she doesn't know what to make of them, he was too sick to try and get an explaination.

Response from Dr. Cohen

The "norm"for a viral load test is "negative," in that HIV-negative individuals have no viral load at all. In an HIV-infected person, there is no "norm" or baseline. Instead, we can simply say that the goal is the lowest possible viral load, preferably negative or undetectable. When people are asymptomatic and have reasonable CD4 cell counts, it would be typical to have a viral load that ranged from several hundred to several thousand, which would be considered low. People with advanced HIV disease can have very high viral loads: above 100,000, and even into the millions. Most people now agree that when the viral load is above 30,000 you should be treated, even if you're feeling fine and have high T-cells. Others would treat before that, at lower viral loads. We then use the reduction in viral load to assess whether our therapy worked, and follow the viral load to detect when the therapy has failed.

Unfortunately, we simply don't know what the "cut-off" point is, if there is one. We can't say that below a certain number, HIV disease will not progress. All we can do is try to achieve the lowest possible viral load with our antiretroviral therapy.



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