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HIV Viral Load Testing: The Basics (Fact sheet)
This document was funded by the Ontario government. It was part
of a larger campaign to educate people in Ontario about the usefulness of viral load
testing and the decisions that viral load testing might prompt. Although most of the
information is applicable across Canada, the testing process varies from province to
province. The tests are not interchangeable and the numerical results obtained in Ontario
can not be compared with those obtained in Quebec. The value at which a viral load is
reported as undetectable may also vary, although currently, in most provinces, it is 500
copies of virus per millilitre of blood. Ultra-sensitive tests which can measure down to
40 or 50 copies/ml are expected to be introduced in Ontario and BC in the summer of 1998
and will probably be available in some other provinces within the year.
Whether you've just found out you are HIV positive or you've known for a while, odds
are right now you're feeling healthy. That's great. The goal of any HIV treatment or test
is to keep you that way. There are things you can do to help keep yourself healthy. For
example, it makes sense to regularly eat a nutritious diet and to get enough sleep. To
help you make more informed decisions, it also makes sense to find out more about HIV,
about treatment options and about what's happening in your own body. One way to find out
what's happening inside your body is to have regular check-ups so your doctor can watch
for any signs of illness. There are also some simple blood tests that can be used to
monitor your health. One of these is the viral load test.
What is a viral load test?
A viral load test measures the amount of HIV in your blood.
Why do I need a viral load test if I've already had an HIV test?
An HIV test tells you and your doctor whether or not you are infected with HIV; the virus
that causes AIDS. A viral load test measures the amount of virus in your blood. Knowing
how much virus is in your blood may help you and your doctor make better decisions about
treatments.
What does a viral load test tell me?
The viral load test helps predict your future health. If your viral load is low, it means
you are less likely to develop AIDS in the near future than someone with a higher viral
load.
How is the viral load test different from a T-cell count?
A T-cell count (or CD4+ test) measures how well your body is coping with HIV infection.
The viral load test lets you know how much virus is present in your blood, regardless of
how your body is dealing with HIV.
What's a normal viral load test?
There is no normal value for a viral load test. It's not normal to have HIV in your blood.
The lower your viral load, the better. If your results are very low, they may be reported
as "undetectable."
And undetectable means...?
With the viral load test currently being used in Ontario, undetectable means there are
less than 500 viruses per millilitre of your blood. New tests are coming which will
measure even smaller amounts of HIV. Undetectable does not mean you have no virus in your
blood. You can still infect someone else, if you share needles or have unprotected sex.
Even with an undetectable viral load, you are still HIV positive.
What can I do to lower my viral load?
Many people have successfully used combinations of anti-HIV drugs to lower the amount of
virus in their blood. These drugs have helped people who were sick get better, and people
who were well stay well. Unfortunately, all of these drugs have side effects. Some people
will experience more severe side effects than others. They don't work for everyone and no
one knows how long they will work. You have to be prepared for changes in your life if you
take these drugs.
Are there any natural or alternative treatments that will lower my viral load?
There have been small studies of some alternative treatments which have lowered viral
load. So far no alternative treatment has been proven to reduce viral load as much as
combinations of prescription drugs. Unfortunately, alternative therapies are rarely
studied in combination with prescription drugs or other alternative forms of treatment.
How can I tell if my treatments are working?
You can't tell from a single viral load test. If your viral load gets lower and stays
consistently lower over several viral load tests, then your treatments are working to
control the amount of virus in your body. Many researchers now believe that the ideal goal
is to have a viral load that is undetectable; however, any consistent decrease in your
viral load is beneficial. You can discuss with your doctor what an appropriate treatment
goal for you would be. If your viral load starts to rise while you are taking treatments,
it might be time to consider taking different drugs. Don't forget, viral load is not the
only way to tell if a treatment is working. Other good signs include rising CD4+ counts,
recovery from existing opportunistic illnesses and, of course, feeling better.
What if I don't want to take drugs right now?
Having a viral load test doesn't mean you have to rush into taking drugs or other
treatments; now or ever. If you are considering drug treatment, think about how you will
deal with treatment side effects and the changes necessary in your daily schedule. Be
prepared for how you will feel if these treatments don't work for you. Having a viral load
test may help you get a better perspective on the decisions you want to make right now.
Having these tests now will also give you better background information for future
decisions.
Is a viral load test always accurate?
If you have the flu or any other short-term illness your viral load may rise. This
increase is temporary. Temporary increases in viral load may also occur after a
vaccination such as the flu shot. Avoid having a viral load test in the week after a
vaccination or an illness.
The number value reported for one viral load test and the number reported for the next
test 2 or 3 months later can vary. Sometimes your doctor will suggest that you have a
second viral load test immediately. This may help to sort out whether there was a
meaningful change in your viral load, or if the difference was due to small changes in
your body or the test procedure. Having your viral load test done at the same time of day
each time may help to reduce misleading differences. Although one test procedure is
standard in Ontario, there may also be variations between laboratories, so try to visit
the same laboratory for each test. Outside of Ontario, completely different test
procedures may be used, particularly for very sensitive tests. Be cautious about comparing
viral load tests done by two different laboratories, especially if the second laboratory
is in another province or country.
If I go for a viral load test, will other people find out I'm HIV+?
It is against the law for your doctor or any of the people who work for him/her to tell
anyone about your test without your permission.
I still need more information about the viral load test. Your doctor is familiar with
your past health and current medical concerns. You can discuss with him or her what a
viral load test might tell you about your health. Your doctor can also help you understand
the meaning of your results after you've had a viral load test. If you or your doctor have
questions about using or interpreting viral load tests, or if you want to know more about
the studies that have been done, call CATIE toll free at 1-800-263-1638. We can also help
answer questions about treatments for HIV and other AIDS-related illnesses.
For more information about viral load testing please see the CATIE fact sheet: Viral
Load Measurement by Lori Lyons, January 1997.
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Funding credits: CATIE would like to thank the Ontario Ministry
of Health, AIDS Bureau, for funding to produce this document. CATIE's HIV/AIDS Treatment
Information Network is funded by the AIDS Care, Treatment and Support Program under the
National AIDS Contribution Program of the National AIDS Strategy, Health Canada.
Disclaimer The Community AIDS Treatment Information Exchange (CATIE)
provides information resources to help people living with HIV/AIDS who wish to manage
their own health care in partnership with their care providers. We do not recommend or
advocate particular treatments and we urge users to consult as broad a range of sources as
possible. While we update our material regularly, users should be aware that information
changes rapidly. Additional information may be available from CATIE at 1-800-263-1638 or
at our website at http://www.catie.ca. Users relying on
the information do so entirely at their own risk. Neither CATIE, the Ontario Ministry of
Health nor Health Canada accept responsibility for any damage that may result from the use
or misuse of this information. Decisions about particular treatments should be made in
consultation with a health care professional knowledgeable about HIV-related illnesses and
the treatments in question.
Permission to Reproduce This document is copyrighted by the Community
AIDS Treatment Information Exchange (CATIE). All CATIE materials may be reprinted and/or
distributed without prior permission. However, reprints may not be edited and must include
the following text: "From Community AIDS Treatment Information Exchange (CATIE). For
more information contact CATIE's Information Network at 1-800-263-1638." For
permission to edit any CATIE material for further publication, please call the CATIE
office.
The author wishes to thank all of the people who contributed their skill
and insight to this leaflet as editors or advisors. They include members of Voices of
Positive Women, Ottawa, the Ontario Viral Load Evaluation Committee and CATIE staff
members Alan Boutiler, Glen Brown, Connie Cole, Deirdre Maclean, Jane Oliver, Jane
Strickland and Ralph Wushke.
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