Plasma viral load testing in the management of HIV infection

Eleftherios Mylonakis, Maria Paliou, Josiah D. Rich

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations

Abstract

The polymerase chain reaction assay, branched DNA assay and nucleic acid sequence-based amplification assay quantitate human immunodeficiency virus (HIV) RNA levels. Plasma viral load (PVL) testing has become a cornerstone of HIV disease management. Initiation of antiretroviral drug therapy is usually recommended when the PVL is 10,000 to 30,000 copies per mL or when CD4+ T-lymphocyte counts are less than 350 to 500 per mm3 (0.35 to 0.50 × 109 per L). PVL levels usually show a 1- to 2-log reduction within four to six weeks after therapy is started. The goal is no detectable virus in 16 to 24 weeks. Periodic monitoring of PVL is important to promptly identify treatment failure. When feasible, the same assay should be used for serial PVL testing in the individual patient. At least two PVL measurements usually should be performed before antiretroviral drug therapy is initiated or changed. PVL testing may be helpful in the rare instance of indeterminate HIV antibody testing, especially in a patient with recent infection.

Original languageEnglish (US)
Pages (from-to)483-490
Number of pages8
JournalAmerican Family Physician
Volume63
Issue number3
StatePublished - Feb 1 2001

ASJC Scopus subject areas

  • Family Practice

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