The NIH has produced guidelines on testing for viral load and treating HIV infection (8). These recommend:
The aim of treatment is to reduce viral load to undetectable levels (<50 copies/mL) for as long as possible as this is associated with a reduced risk of developing AIDS and a reduced risk of developing resistance to the drugs being taken. For example, a patient with a viral load of 60,000 copies/mL has a high probability (32.6%) of progressing to AIDS within three years whereas one with a viral load of 18,000 copies/mL has a low chance (5.9%) of developing AIDS in the next three years (2).
New diagnostic tests are far more sensitive at detecting HIV and are lowering the level at which viral load can be measured. AMPLICOR HIV-1 MONITOR® Test with UltraSensitive sample preparation method, for example, can detect as little as 50 RNA copies / mL.
More sensitive viral load tests will help to improve our ability to monitor the progress of HIV and the effectiveness of therapy. The NIH guidelines note that reducing viral load below 50 RNA copies / mL "is associated with a more complete and durable viral suppression, compared with reducing HIV RNA to levels between 50-500 copies / mL".
New anti-HIV drugs and potent combination therapies are making it possible to reach such low viral load levels. In recent clinical studies, the SPICE (5) and CHEESE (6) trials, HIV positive individuals were monitored using AMPLICOR HIV-1 MONITOR® Test with UltraSensitive method and were able to achieve viral loads below the level of detection ie. below 50 RNA copies/mL.
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