{"id":86,"date":"2023-01-01T12:00:54","date_gmt":"2023-01-01T12:00:54","guid":{"rendered":"http:\/\/moomango.co.uk\/ttfa\/?page_id=86"},"modified":"2023-01-12T10:59:58","modified_gmt":"2023-01-12T10:59:58","slug":"6-viral-load-in-early-and-chronic-infection","status":"publish","type":"page","link":"https:\/\/i-base.info\/ttfa\/section-2\/6-viral-load-in-early-and-chronic-infection\/","title":{"rendered":"2. 6 Viral load in early and chronic infection"},"content":{"rendered":"<p><strong>The natural history of an illness describes the pattern of a disease if it is not treated.<\/strong><\/p>\n<p>It is important to know about the natural history of HIV.<\/p>\n<h2>Natural history of HIV<\/h2>\n<p><strong>The natural history of HIV infection has several different stages. <\/strong><\/p>\n<p>These stages include:<\/p>\n<ul>\n<li>Infection.<\/li>\n<li>Seroconversion.<\/li>\n<li>Primary infection.<\/li>\n<li>Chronic infection.<\/li>\n<li>Late-stage illness.<\/li>\n<\/ul>\n<p>HIV treatment (ART) stops most HIV-related illnesses and infections.<\/p>\n<h4>Infection<\/h4>\n<p><strong>This is when HIV gets into your body and infects the first cells.<\/strong><\/p>\n<ul>\n<li>It then takes several hours for these newly infected cells to carry HIV\u00a0to the lymph nodes.<\/li>\n<li>During the next few days or weeks, HIV continues to multiply in the lymph nodes closest to the infection. After sexual transmission, this will be lymph nodes near your groin.<\/li>\n<li>Lymph nodes contain CD4 cells that are either active or asleep. Active cells allow HIV to replicate.<\/li>\n<\/ul>\n<h4>Seroconversion<\/h4>\n<p><strong>After building up in the first infected lymph nodes, these nodes\u00a0burst, sending HIV into the blood. \u00a0<\/strong><\/p>\n<p>This sends HIV throughout the body. HIV levels (viral load) become detectable in blood and reaches very high levels (often millions of copies\/mL).<\/p>\n<p>As viral load increases, this high level of viral activity produces symptoms in up to 80% people. These seroconversion symptoms include night sweats, fevers, weakness and tiredness and, more rarely, mouth ulcers.<\/p>\n<p>The immune system reacts to viral load in the blood\u00a0by\u00a0producing antibodies to fight HIV. It usually takes 1-3 months after infection for HIV antibodies to be strong enough to be detected on an HIV antigen test. Occasionally this can take longer.<\/p>\n<h4>Primary (HIV) infection \u2013 PHI<\/h4>\n<p><strong>PHI is also called early infection or acute infection. <\/strong><\/p>\n<p>Primary infection describes the first six months after infection.<\/p>\n<h4>Chronic infection<\/h4>\n<p><strong>Chronic infection describes HIV infection after the first six months.<\/strong><\/p>\n<p>Without ART, it can take from 2-10 years until most people get HIV-related symptoms.<\/p>\n<p>With ART, chronic infection can be life-long \u2013 ie 20, 30, or 40 or more years after infection.<\/p>\n<h4>Late stage infection<\/h4>\n<p><strong>Late stage infection is the most serious stage.<\/strong><\/p>\n<p>Late stage HIV is now more rare.<\/p>\n<ul>\n<li>It is only seen in people who are either diagnosed very later or who do not have access to ART, or who do not use ART.<\/li>\n<li>It is also seen when treatment has stopped working because HIV has become resistant to drugs.<\/li>\n<li>Late-stage HIV used to be called AIDS, but the term AIDS is now rarely used.<\/li>\n<\/ul>\n<h2>Effect of ART on viral dynamics of HIV infection<\/h2>\n<p><strong>After starting\u00a0ART, viral load should go down by at least 90% (1 log) within the first week &#8211; mostly in the first few days.<\/strong><\/p>\n<p><strong>After\u00a0starting ART viral load should then become undetectable (less than 50 copies\/mL) within three\u00a0months. Some people become undetectable after only a month. For some people this takes longer.<\/strong><\/p>\n<p>How quickly viral load becomes undetectable depends on three main factors.<\/p>\n<ol>\n<li>How high viral load is when ART is started.<\/li>\n<li>How good someone is at taking their meds and not missing doses.<\/li>\n<li>Which HIV drugs are in the combination. <a href=\"https:\/\/i-base.info\/guides\/category\/arvs\/integrase-inhibitors\">Integrase inhibitors<\/a> reduce viral load quicker that other types of HIV drugs.<\/li>\n<\/ol>\n<p><strong><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-87\" src=\"https:\/\/i-base.info\/ttfa\/files\/2009\/06\/infection.gif\" alt=\"Course of HIV infection\" width=\"432\" height=\"240\" \/><br \/>\n<\/strong><\/p>\n<ul>\n<li>A few weeks after infection, HIV viral load shoots up to very high levels. This is when someone is most infectious.<\/li>\n<li>Then your body fights back. Viral load drops to much lower levels in most people.<\/li>\n<li>Without ART, over the next 2-10 years viral load increases slowly. Viral load usually becomes very high (around 50,000-200,000 copies\/mL) by the time the\u00a0CD4 count drops to 350 cells\/mm<sup>3<\/sup>.<\/li>\n<li>All treatment guidelines should now recommend ART for all people living with HIV.<\/li>\n<li>ART stops HIV stops reproducing once\u00a0viral load becomes undetectable.<\/li>\n<\/ul>\n<p><strong>After ART brings viral load down to less than 50 copies\/mL, treatment can continue working for many years.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The natural history of an illness describes the pattern of a disease if it is not treated. It is important to know about the natural history of HIV. Natural history of HIV The natural history of HIV infection has several &hellip;<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":76,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-86","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/i-base.info\/ttfa\/wp-json\/wp\/v2\/pages\/86","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/ttfa\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/i-base.info\/ttfa\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/ttfa\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/ttfa\/wp-json\/wp\/v2\/comments?post=86"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/ttfa\/wp-json\/wp\/v2\/pages\/86\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/i-base.info\/ttfa\/wp-json\/wp\/v2\/pages\/76"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/ttfa\/wp-json\/wp\/v2\/media?parent=86"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}