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What Is a Viral Load?

By Justina Thompson

Fall 1998

A viral load is a test that can actually measure how much virus is in your blood stream. The viral load test can be done when you have your blood drawn for T-cells or other standard lab tests. Basically, it measures the HIV virus' activity in your blood. The amount of virus in your blood also shows you how quickly or slowly the virus is multiplying. In general if your virus is very active, the T-cells will be destroyed and your T-cell count can begin to go down.


When you are first infected with HIV, the virus replicates very fast and your viral load can be greater than 1 million. As your T-cells respond, the virus slows down and it reaches what is called a "set point." This is the place where your virus is suppressed by your T-cells. In addition, this number can be different with each HIV infected individual. The higher your viral load is, the faster you will lose T-cells and progress to an AIDS diagnosis.

Using antiretrovirals can help your immune system to fight HIV. These medicines are used to suppress the virus and keep your T-cell count high so that you do not get sick. Each person will react differently to the medications. Some people have side-effects. These side effects can be minor and almost insignificant, or they can be major and debilitating. Most of the time, side effects will go away after a few weeks of using medications. Other times, side effects can be long lasting, but often will not prevent you from going about your daily business. Some people need an intensive drug combination to control their viral replication. Other people may need less medications to do the same thing.

Stay Healthy

The goal is to get your viral load as low as possible. This is how you keep your immune system working and fighting against sickness. Whether you are taking medications or not, you should monitor your viral load every three months. If your viral load is undetectable, it does not mean that you are now HIV-negative or that the virus is totally gone from your body. It just means that the tests cannot measure low enough to detect all the virus in the blood. The tests do not measure how much virus is in the lymph system or other hiding places.


If your viral load is undetectable and you stop your medications, or take a drug holiday, or miss dosages, your viral load will begin to increase and return to a new set point. Your viral load can go up much more quickly than the medications can bring it back down. It is often best to keep taking the medications so that your viral load can stay down. Sometimes even while taking medications, your viral load can become detectable or go up higher than before.

If your viral load changes, you need to have another viral load test to double check the results. Sometimes there can be a mistake, so two tests in a row are better than one. If it keeps going up, it's time to make a decision about what medication you will try next, or to start medications if you haven't yet. It is important that you always have your viral load measured at the same place each time, because you can not compare different tests (such as a PCR to a bDNA), or one lab to another.

Know Where You Stand

Keep track of your viral load and your T-cells, so that you will always know where you stand. The viral load will measure how active your virus is and the T-cell count will tell you how suppressed your immune system is. Both tests are important and tell you different things about your health.

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