CD4 and Viral Loads
The virus multiplies rapidly and disables more and more of the. CD4 cells. • As the CD4 count drops and the viral load increases, the body is not able to defend. Dear Dr. Gary, I had been dating this guy for a month or so, and we decided it lot more important than the dating tips you might be reading about, .. to for get about the pcv, cd4 and viral load.. i really used the medicine and. There's no direct relationship between CD4 count and viral load. However, in general, a high CD4 count and a low — or undetectable — viral.
A viral load can include millions of copies per mL of blood, especially when the virus is first contracted.
CD4 vs. Viral Load: What’s in a Number?
A low viral load indicates relatively few copies of HIV in the blood. If an HIV treatment plan is effective, a person will be able to maintain a lower viral load.
However, in general, a high CD4 count and a low — or undetectable — viral load are desirable. The higher the CD4 count, the healthier the immune system. The lower the viral load, the likelier it is that HIV therapy is working. How often might someone be tested? A healthcare provider will likely conduct CD4 counts and viral load tests more often at the beginning of HIV therapy or with any changes in medications. Most people living with HIV should have lab tests performed every three to four months, according to current lab test guidelines.
Less frequent testing may be needed for people who take daily medication or have maintained a suppressed viral load for over 2 years. They may only need to be tested twice a year.
Why is it important to get tested regularly? A single CD4 or viral load test result only represents a snapshot in time. Keep in mind that these values may vary for many reasons, even throughout the day. The time of day, any illnesses, and recent vaccinations can all affect CD4 count and viral load. The goal of HIV therapy is to reduce or suppress the viral load to an undetectable level. The exact number depends on the lab that analyzes the tests. Blips Some people may experience blips.
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These are temporary, oftentimes small increases in viral load. A healthcare provider will monitor the viral load more closely to see if it returns to an undetectable level without any change in therapy. Drug resistance Another reason for regular viral load tests is to monitor any drug resistance to the prescribed HIV therapy. Maintaining a low viral load reduces the risk of developing resistance to the therapy. Lack of suppression increased the risk of mortality upwards of 6-fold depending on time on ART and current CD4.
Conclusions Our findings show that while CD4 count is the strongest predictor of death, the effect is modified by viral load and the duration of ART. Assessment of risk should take into account all three factors.
HIV & AIDS Information :: CD4, viral load & other tests - Viral load
However, in low income countries, including those in sub-Saharan Africa, an estimated 6. Globally, as ART patients begin to age and remain on treatment longer, baseline predictors of poor outcomes, though valuable, may not provide as much information about long-term risk of HIV-related morbidity and mortality as measures updated over the course of treatment.
Other measures of sustained immunosuppression, such as cumulative person time with low CD4 cell counts e. While CD4 cell count is the strongest determinant of mortality in HIV-positive patients who adhere to ART, few studies conducted in rich settings have directly explored the interactive relationship between CD4 count, viral load and time on treatment [ 2526 ].
One study suggests that long-term changes in CD4 cell count after ART initiation depend on interactions between CD4 cell count at treatment initiation, viral load response, and time on treatment. Though this study did not assess the impact of these factors on mortality, it provides some insight into the interplay between these three crucial factors in determining overall patient risk for mortality during treatment.
As none of these studies addressed the interaction between CD4 count and viremia, we set out to accurately measure the risk of mortality of patients on ART over time as a function of the interaction between current CD4 count, viral suppression and time on ART over the first six years of treatment using data from one of the largest HIV treatment clinics in South Africa Themba Lethu Clinic in Johannesburg. The study was conducted as an unlinked, prospective analysis of a data set that did not contain any individual identifiers.
Study site Themba Lethu Clinic was opened at the Helen Joseph Hospital in April and has enrolled nearly 31, patients in care [ 7 ]. More than 22, of these patients have stated ART. All laboratory work is processed by the National Health Laboratory Service. First-line ART regimens before April consisted of stavudine or zidovudine with lamivudine and either efavirenz or nevirapine [ 28 ].
Tenofovir was substituted for stavudine after April [ 29 ]. After treatment has begun, patients are seen for follow-up visits and antiretroviral drug pickups monthly for the first 6—12 months on treatment, then every 2 months thereafter if stable.
Study population We performed a cohort analysis of data collected prospectively as part of routine care at the Themba Lethu clinic. Patients included contributed both a CD4 count and a viral load measure during at least one month time period.
We excluded pregnant women as they are initiated on ART at higher average CD4 counts and have variable CD4 counts compared to the general population [ 30 ]. Study Variables The primary outcome for this study was death. Eligible patients contributed person-time from the date of ART initiation until the date of the earliest of: For analysis we divided person-time for each subject into month periods starting from ART initiation.