HIV can seriously affect your long-term health. But there are many nuances to how this can happen.
A patient’s viral load is closely related to how HIV may affect them later in life.
Let’s get into it.
HIV can be easily treated with the right treatment and medication. Know your sexual health status with a comprehensive HIV test.
Can you have more or less HIV?
If you get HIV, you will have it for life. But the extent to which HIV can spread to other people and affect your health will depend on you viral load.
In short, your viral load is determined by how much HIV you have in your blood. Without treatment, the levels of the virus in your blood will increase over time, increasing the chance of passing on the infection, as well as negative health outcomes.
But that’s not the case for most people. The vast majority of people living with HIV in the UK are on antiretroviral therapy (ART), which significantly reduces their viral load.
HIV treatment has become so effective in recent years that many people on ART will have undetectable levels.
What does “undetectable” mean?
Having an undetectable viral load means that the level of HIV in your blood is below a certain threshold that is not detectable in standard tests. This is usually defined as having fewer than 20 to 50 copies of HIV per milliliter of blood.
Having and maintaining an undetectable viral load helps protect your immune system from the damage caused by HIV. If you have an undetectable viral load, you also cannot spread the infection to someone else. Most people can reach an undetectable viral load after six months of treatment.
It is very important that people taking ART continue to take their medication. Missed doses can lead to an increased viral load.
What if my viral load is detectable but still low?
Not everyone will achieve an undetectable viral load. In a small number of cases, HIV-infected individuals who are still taking ART will have a detectable viral load. This condition is called low-level viremia (LLV).
What constitutes LLV is still up for debate, and the defined levels vary from country to country. They can range from 51 to 999 copies per milliliter of blood. It is important to note that viral loads can sometimes increase temporarily on their own and this is not necessarily an indication of treatment failure.
LLV is unlikely to be caused by non-adherence to ART. It is more likely to be caused by other factors. Having LLV also will not increase the chance of sexual transmission. Studies have revealed that maintaining a viral load below 1,000 copies per milliliter of blood reduces the risk of transmission to almost zero.
What are the risks of long-term LLV?
Having LLV, while certainly better than having HIV without treatment, can come with some unwanted health problems.
Virological failure
If you have HIV and have been on ART for more than six months and your viral load remains above 200 copies per milliliter, you will have virological failure. This condition can be a major concern for people trying to manage their HIV, as it can indicate the risk of disease progression.
However, the presence of LLV does not always lead to virological failure. Therapies developed after 2012 have been shown to be protective, as have integrase inhibitor-based regimens.
Conditions not related to AIDS
LLV is associated in some studies with a 31% increase in the risk of serious non-AIDS events, compared to remaining virally suppressed. Virological failure increases the risk of a major non-AIDS event by 75%.
Some health conditions associated with LLV include:
- Chronic kidney disease
- Heart disease
- Prostate cancer
- Anal cancer
- Deep vein thrombosis (DVT)
- Cirrhosis of the liver
We don’t know why this is happening. One theory holds that persistent low-level viremia consistently activates the immune system, which can damage your body over time. More research is needed in this area to find the true cause. However, more recently studies have suggested that these links may not be as strong as previously thought.
How do I find out my viral load?
Viral load can be detected within a few weeks after the initial infection. You can have a viral load test to determine how much HIV you have in your blood. If you are being treated for HIV, you should have regular viral load tests to monitor your status.
Final thoughts
Before you can determine your viral load, you need to know your sexual health status. If you are concerned about a recent sexual encounter, you can get tested at a sexual health clinic near you. Click the button below to book your appointment today.
Don’t leave your sexual health to chance.
