for Veterans and the Public
HIV viral load (or 'HIV RNA')
HIV viral load tests measure the amount of HIV in the blood. Lower levels are better than higher levels. The main goal of HIV drugs is to reduce viral load as much as possible for as long as possible; for most patients, the goal is to suppress HIV viral load to an "undetectable" level, meaning that the HIV RNA is below the detection limit of the test.
The lower limit of HIV RNA detection depends on the test used, some go down to 50 copies/ml, while other go as low as 20. High viral loads are linked to faster disease progression. Reducing the viral load to "undetectable" levels slows or stops disease progression. Treatment for HIV suppresses the virus but does not eliminate it. Even if HIV levels are undetectable, the HIV is still in the body and will rebound to detectable if the HIV medicines are stopped.
The lower your viral load, the better.
CD4 counts and HIV viral load tests are usually done when you first see a new provider and about every 3 months afterwards. Results can help you and your doctor decide how quickly to start taking anti-HIV drugs (more on this in Treatment Decisions), and for people on HIV drugs, to tell whether the drugs are working.