HIV 1 RNA PCR Quantitative(Viral load), EDTA Plasma

The HIV viral load test is used initially, along with a CD4 count, to determine the status of HIV infection in a person diagnosed with the disease. The viral load is then used to monitor the effectiveness of antiretroviral treatment (ART) over time. HIV viral load testing measures the amount of HIV genetic material (RNA) in the blood and reports how many copies of the virus are present. Evidence shows that keeping the viral load at undetectable levels decreases an infected person's risk of progressing to AIDS and greatly improves long-term health. It is recommended that all individuals diagnosed with HIV infection receive antiretroviral treatment as soon as possible, including pregnant women. People typically take at least three drugs from two different classes in order to prevent or minimize virus replication and the emergence of drug-resistant strains. Combinations of three or more antiretroviral drugs are referred to as highly active antiretroviral therapy or HAART. The HIV viral load may also be used to help determine whether the virus infecting a person has become drug-resistant. If a person does not respond well to treatment and the amount of virus continues to increase, then the virus may be resistant to that particular ART. The person's treatment will then likely be modified. HIV viral load tests are most useful when they are compared with results obtained from earlier tests. They are used in combination with the CD4 count to monitor how effective ART is in suppressing the virus. CD4 cells are types of white blood cells that fight infection and play an important role in immune system function. They are the main target of HIV. The virus enters the cells and uses them to make copies of itself (replicate) and spread throughout the body. HIV kills CD4 cells as it replicates. If HIV is not detected early and treated, the viral load will increase and the number of CD4 cells will decrease.

Will exercise, nutrition, and other lifestyle modifications help decrease my HIV viral load?

There is no direct link between HIV viral load and exercise, nutrition, or other lifestyle factors. However, the Centers for Disease Control and Prevention (CDC) does suggest that if you eat healthy foods, you will stay strong and keep up your energy. More information about this is contained in the CDC brochure Living with HIV (link is external). (link is external)

If I have undetectable HIV viral load, can I still spread the disease?

Yes. Although having an undetectable viral load will decrease the chances of you spreading the disease to others, it can still happen. An undetectable viral load only means that there are too few copies of the virus present in the blood to be detected by the test. The virus can still be present in body fluids, such as semen and vaginal fluids, so you can still spread the virus if you have unprotected sex.

Can an HIV RNA test be used to screen for HIV?

The recommended test for HIV screening is a combination test that detects HIV antibody and HIV antigen. By detecting both antibody and antigen, the combination test increases the likelihood that an infection is detected soon after exposure. Most HIV screening tests detect only HIV antibody but are good options for screening because they may be available as rapid tests and at the point of care. If any of these screening tests are positive, they must be followed by another different antibody test. If the second test is positive, then HIV diagnosis is confirmed. If however, the first and second result do not match, then an HIV RNA test may be done to help establish a diagnosis.

Why is the HIV RNA test used to test newborns for HIV infection?

Babies born to mothers infected with HIV are typically tested soon after birth (usually within one to four months) to help determine whether the mother has passed the infection to her baby. An HIV RNA test is performed in babies instead of standard screening HIV antibody tests because antibodies to HIV produced by the mother can cross the placenta and enter the baby's blood. If an HIV antibody test were to be performed on a baby, the result could be positive even though the baby is not infected with the virus.

An infant with a positive HIV RNA test is likely infected with the virus. Repeat testing done on a second blood specimen is done to confirm the diagnosis. A negative HIV RNA test means that the baby is not infected (or may have been tested too soon after birth). If negative, the test is usually repeated when the infant is older than 1 month and again when the baby is older than 4 months. This may be necessary as the amount of virus may not be at a detectable level.