Question
My viral load is 10 million copies/mL in seroconversion…
6 January 2022. Related: CD4 and viral load, Newly diagnosed, Starting treatment.
Hi,
I was recently diagnosed with HIV. It is thought I contracted this within a few months ago. The ID doctor seems to think I am seroconverting.
My first lab results shocked me. My CD4 was 267 with a VL over 10 million. I feel healthy with just a slight dry throat and had recededing gums which has eased off. I am 30 years old, 6ft and weigh 11 stone.
My question is why such a high initial VL?
Does this indicate any problems with future CD4/VL i.e being VL being above 100,000 and so needing immediate treatment.
How soon could I expect my levels to level?
Many thanks
Answer
Hi
I’m sorry to hear about your diagnosis, but I hope you are getting the information and support to make this easier.
It is common for viral load in very early infection to be over one million copies/mL.
The two studies referenced below report cases in seroconversion where this is greater than 50 million. Viral load tests are less sensitive at very high levels (over one million) so these very high figures just show these are possible.
The severity of seroconversion symptoms is an indication of how quickly HIV progresses after serconversion. People who have the worst symptoms often start HIV treatment earlier. Also, if symptoms are severe enough to be hospitalised, BHIVA guidelines include this as a reason to start HIV treatment.
UK guidelines generally recommend starting HIV treatment (ART) whenever someone is diagnosed. This includes in very early infection, even if you don’t have symptoms. See from page 33 at this link: https://www.bhiva.org/file/RVYKzFwyxpgiI/treatment-guidelines-2016-interim-update.pdf).
This also recognises that someone has to be ready to start treatment, but a high viral load is one of the reasons used to support early ART.
References
The first study reports median peak viral load of 6.5 log (3 million) with a range of 4.2 to 9.0 log) at median of 10 days (range 1 to 31) post symptoms.
The second study includes an example of a women in Kenya in early infection with a viral load of 57 million copies/mL.
- Kaufmann GR et al.Impact of Early HIV-1 RNA and T-Lymphocyte Dynamics During Primary HIV-1 Infection on the Subsequent Course of HIV-1 RNA Levels and CD4+ T-Lymphocyte Counts in the First Year of HIV-1 Infection. JAIDS 22(5)437–444. (15 December 1999).
https://journals.lww.com/jaids/Abstract/1999/12150/Impact_of_Early_HIV_1_RNA_and_T_Lymphocyte.3.aspx - Lavreys L et al. Virus Load during Primary Human Immunodeficiency Virus (HIV) Type 1 Infection Is Related to the Severity of Acute HIV Illness in Kenyan Women. Clinical Infectious Diseases, 35(1): 77–81. DOI: 10.1086/340862. (1 July 2002).
https://academic.oup.com/cid/article/35/1/77/282492
This answer was updated in January 2022 and January 2016 from a question first posted in August 2010. The update is because guidelines now recommend ART in early infection.
Current thought is to treat immediately upon diagnosis, not to wait at all. Studies have demonstrated lower mortality when patie ts are started in HART immediately upon a positive diagnosis, regardless of viral load. Don’t wait, get treated. Now.
Hi Zodumo,
What is your viral load history? Are you taking your medication as prescribed?
When a persons viral load increases and they are adhering to their medication,this is a sign that resistance has occurred. When this happens there will need to be a change in medication. There’s more about this here: http://i-base.info/guides/changing
I’m worried my viral load increased whereas I am taking ARVs,what must I do? while I was taking some blood test and the result showing that my viral load increased in the lab they suggested that the clinic must change my medication but in they didn’t,i am not sick and not loose weight what must I do because I am worried about this increasing viral load?
Hi Gidion,
It’s great that you’ve started HIV medication (ART). Most guidelines recommend starting treatment at any CD4 count. Please see questions 7 and 8 at this link to frequently asked questions.
Viral load I was recently tested for first time in life after continued loss of appetite and fever.am 54. My viral load was 34000 and cd4 count at 125 .what does this mean.have started with medication
How safe am I
Hi Charmeylina,
For how to live well with HIV, please see here:
http://i-base.info/guides/side
I want to know what’s side effect of HIV treatment for long term???How about to protect kidney,and all that.
Hi Steve,
I hope your treatment was successful and that you are now at undetectable virus load levels. I was diagnosed with HIV three months ago and it must have occurred just at the beginning of my infection. My virus load was above 76 million / ml blood, which apparently was unheard of by my doctor. I has now decreased to 240 / ml blood and I hope to be undetectable within the next months to come!
Cheer,
Chris
Hi Steve,
I’m very sorry to hear about your recent diagnosis and how difficult this is for you. Do you have any support to help you deal with this?
If you do have any questions about treatment or would like any information please get in touch with i-Base by email or on our phoneline – 0808 800 6013
I was recently diagnosed and I am having extreme symptoms. my vl is still over 20 million and my body refuses to produce any antibodies I started treatment the day I was diagnosed (25th September) and I have to have bloods every week to monitor,
Hopefully all goes well but I have had such a bad time with trying to cope with this. I also have receding gums and feel every morning like I’ve been hit in the face with a hammer not nice.
I hope everything goes well for u and hope u feel well.