What is a viral load?

HIV病毒载量是在血液中测量的HIV量。艾滋病毒治疗的目的是降低病毒载量，以至于无法检测到。也就是说，目标是减少足够的血液中的艾滋病毒量，以便在实验室测试中无法检测到。

与生活在一起的人HIV, it can be helpful to know their own HIV viral load because it tells them how well their HIV medication (antiretroviral therapy) is working. Read on to learn more about HIV viral load and what the numbers mean.

HIV attacks CD4 cells (T-cells). These are white blood cells, and they’re part of the immune system. ACD4计数provides a rough assessment of how healthy a person’s immune system is. People who don’t have HIV usually have a CD4 cell count between500和1,500。

A high viral load can lead to a lowCD4 cell count。When CD4 count is below 200, the risk of developing an illness or infection is higher. This is because having a low CD4 cell count makes it harder for the body to fight infection, increasing the risk of illnesses such as severe infections and some cancers.

未经治疗的艾滋病毒会导致其他长期并发症，并可以发展成AIDS。However, when HIV medication is taken daily as prescribed, the CD4 count tends to increase over time. The immune system gets stronger and better able to fight infections.

测量病毒载量和CD4细胞计数显示HIV treatment is working both to kill the HIV in the bloodstream and to allow the immune system to recover. The ideal results are to have an undetectable viral load and high CD4 count.

病毒载荷测试表明1毫升血液中的HIV有多少。在开始治疗之前有人被诊断出患有HIV的时候，进行病毒负荷测试，并不时再次确认其HIV治疗正在起作用。

Raising CD4 count and lowering viral load requires taking medication regularly and as instructed. But even if a person takes their medication as prescribed, other prescription and over-the-counter (OTC) medications, recreational drugs, and herbal supplements they use can sometimes interfere with the effectiveness of HIV treatment. It’s always a good idea to check with a doctor before starting any new medications, including OTC and prescription drugs and supplements.

如果测试表明，一个人的病毒负荷尚未变得无法检测到，或者从无法检测到可检测到，他们的医生可能会调整其抗逆转录病毒疗法方案以使其更有效。

The higher the viral load, the higher the probability of passing HIV on to someone else. This could mean passing the virus to a partner through sex without a condom, to someone through sharing needles, or to a baby during pregnancy, delivery, or breastfeeding.

当始终如一地服用时，抗逆转录病毒药物会降低病毒载量。这种降低的病毒负荷降低了将艾滋病毒传递给其他人的风险。另外，不始终服用这种药物或完全增加了将艾滋病毒传递给他人的风险。

拥有无法检测的病毒负荷并不意味着一个人的治愈，因为艾滋病毒仍然可以藏在免疫系统的其他部位。相反，这意味着他们正在服用的药物有效抑制病毒的生长。只能通过继续服用这种药物来实现持续的抑制。

Those who stop taking the medication risk having their viral load go back up. And if viral load becomes detectable, the virus can be passed to others through bodily fluids such as semen, vaginal secretions, blood, and breast milk.

性传播

有一个检测不到病毒载量意味着risk of passing HIV to someone else is effectively zero, assuming that the person with HIV and their partner don’t have any sexually transmitted infections (STIs).

Two 2016 studies, in the Journal of the American Medical Association and新英格兰医学杂志, found no transmission of the virus from an HIV-positive partner who had been on antiretroviral therapy for at least six months to an HIV-negative partner during sex without condoms.

However, researchers are unsure about the effects of STIs on risk of HIV transmission in treated individuals. Having an STI might increase the risk of transmitting HIV to others even if HIV isn’t detectable.

Transmission during pregnancy or breastfeeding

对于怀孕和患有艾滋病毒的妇女，怀孕期间服用抗逆转录病毒药物和劳动会大大降低向婴儿传播艾滋病毒的风险。许多患有艾滋病毒的妇女能够通过获得良好的产前护理，包括对抗逆转录病毒疗法的支持。

Babies born to HIV-positive mothers receive HIV medication for four to six weeks after birth and are tested for the virus over the first six months of life.

According to the 疾病控制与预防中心（CDC） , a mother with HIV should avoid breastfeeding.

随着时间的流逝，跟踪病毒负荷很重要。任何时候病毒载荷增加，最好找出原因。病毒载荷的增加可能出现许多原因，例如：

  • not taking antiretroviral medication consistently
  • the HIV has mutated (changed genetically)
  • 抗逆转录病毒药物不是正确的剂量
  • a lab error occurred
  • 患病

如果在接受抗逆转录病毒疗法治疗时无法检测到的病毒负荷增加，或者尽管没有治疗，但医疗保健提供者可能会下令进行额外测试以确定原因。

The frequency of viral load testing varies. Typically, viral load testing is done at the time of a new HIV diagnosis and then intermittently over time to confirm that antiretroviral therapy is working.

A viral load usually becomes undetectable within three months of starting treatment, but it often happens faster than that. A viral load is often checked every three to six months, but it may be checked more often if there is concern that the viral load may be detectable.

Whatever their viral load, it’s a good idea for people living with HIV to take steps to protect themselves and their sexual partners. These steps may include:

  • Taking antiretroviral medication regularly and as directed.当正确服用时，抗逆转录病毒药物会减少病毒载量，从而降低向他人传播HIV的风险。一旦病毒载荷变得无法检测，通过性传播的风险实际上为零。
  • Getting tested for STIs.Given the potential effect of STIs on risk of HIV transmission in treated individuals, people with HIV and their partners should be tested and treated for STIs.
  • Using condoms during sex.使用避孕套并从事不涉及体液交换的性活动会降低传播风险。
  • 考虑准备。合作伙伴应与他们的医疗保健提供者讨论预防前预防或准备。该药物旨在防止人们患艾滋病毒。按照规定，它会降低通过性别获取艾滋病毒的风险90 percent。
  • Considering PEP.怀疑他们已经接触艾滋病毒的合作伙伴应该与他们的医疗保健提供者谈论post-exposure prophylaxis (PEP).This medication reduces the risk of infection when it’s taken within three days after possible exposure to HIV and continued for four weeks.
  • Getting tested regularly.Sexual partners who are HIV-negative should get tested for the virus at least once a year.

艾滋病毒诊断可能改变生活，但仍然有可能健康和活跃。早期诊断和治疗可以降低病毒负荷和疾病风险。任何担忧或新症状都应引起医疗保健提供者的注意，应采取措施以健康生活，例如：

  • getting regular checkups
  • 服药
  • exercising regularly
  • eating a healthy diet

值得信赖的朋友或亲戚可以提供情感支持。同样，许多本地支持小组也适用于艾滋病毒及其亲人的人。可以在州划分的艾滋病毒和艾滋病小组的热线ProjectInform.org。

Read this article in Spanish。