Question

How will 12 years of ART effect viral load? The CD4 count is 400.

5 September 2016. Related: All topics, CD4 and viral load, Living with HIV long-term.

I know someone who has a CD4 count of about 400 and has been on ART for 12 years. Can it be possible to have a high viral load with a CD4 count of about 400 and takes medication daily?

Answer

Answer: Muirgen Stack

Hi there,

Thanks for your question.

The only way you can know if someone has a high or a low viral load is to have a viral load test.

Although viral load is common in most countries, some countries do not have this technology yet. This is something that is best asked for from a doctor.

The only way you could guess about viral load would be looking at changes in CD4 count over time.

Do you mind me asking if you know what the CD4 count was a diagnosis and how much it has increased or decreased by? As the person has been on ART for 12 years their CD4 count have varied quite a lot depending on how their adherence has been over all of that time. It is a good sign that they take their medication daily.

For example  If the CD4 count had been steadily increasing for more than two years, AND if the person is currently good at taking their meds they would be quite likely to have an undetectable viral load. Most people who get undetectable on their first treatment, stay undetectable for many years – so long as they are taking their meds.

Conversely, if their CD4 count has been steadily decreasing and they aren’t good at taking their meds, their viral load may be detectable.

Unfortunately this is all guesswork without viral load and that’s why it important try and access viral load testing if available or advocate for access if not available in your friend’s country yet.