HIV can seriously affect your long-term health. But there are many nuances about how this can happen.
A patient’s viral load is closely linked to how HIV may affect him later in life.
Let’s get into it.
HIV can be easily treated with proper 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 suffer from it for life. But the extent to which HIV can spread to other people and affect your health depends on your situation viral load.
In short, your viral load is determined by the amount of HIV you have in your blood. Without treatment, your virus levels in your blood will increase over time, increasing the chance that you will pass on the infection, as well as negative health outcomes.
But for most people this is not the case. The vast majority of people living with HIV in Britain 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?
If you have an undetectable viral load, it means that the level of HIV in your blood is below a certain threshold that is undetectable with 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 HIV causes. If you have an undetectable viral load, you also cannot transmit the infection to someone else. Most people can achieve an undetectable viral load after six months of treatment.
It is very important that people on ART continue to take their medications. Missed doses can lead to an increased viral load.
What should I do 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 people who are still on 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 established levels vary from country to country. They can range from 51 to 999 copies per milliliter of blood. It is important to note that sometimes the viral load can temporarily increase on its own, and this is not necessarily an indication of treatment failure.
LLV is unlikely to be caused by nonadherence to ART. It is more likely to be caused by other factors. Having LLV will also not increase the chance of sexual transmission. Studies have shown that maintaining a viral load of less than 1,000 copies per milliliter of blood reduces the risk of transmission to almost zero.
What are the risks of long-term LLV?
While having LLV is certainly better than having untreated HIV, some unwanted health problems can still occur.
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 have virologic 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, having LLV does not always result in virological failure. Treatments developed after 2012 have proven protection, as have integrase inhibitor-based treatments.
Non-AIDS related conditions
LLV has been associated with a 31% increase in the risk of serious non-AIDS events in some studies, compared with remaining virally suppressed. Virological failure increases the risk of a serious non-AIDS event by 75%.
Some health problems associated with LLV include:
- Chronic kidney disease
- Heart disease
- Prostate cancer
- Anal cancer
- Deep vein thrombosis (DVT)
- Liver cirrhosis
We don’t know why this happens. One theory holds that having 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 may be detectable within weeks of initial infection. You can have a viral load test done 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 condition.
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.
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