Viral Load and Transmission: An information sheet for people with HIV.

 

Same as Incommunicable? I do not know…

Key Points:

  • Effective HIV treatment reduces the amount of the virus in your body fluids.
  • Having an undetectable viral load greatly reduces your chance of transmitting HIV to someone else.
  • HIV treatment is as effective as the consistent use of condoms in preventing HIV transmission during vaginal sex.

The amount of HIV in your body fluids is called viral load. Effective HIV treatment (antiretroviral therapy or ART) suppresses the presence of HIV RNA to the point where it can no longer be detected by the tests used in clinics. An important observation of me, the site editor, is that these tests have several levels of sensitivity and there are tests capable of measuring from five copies of RNA and the reason to use the one, able to detect up to forty copies and not this, able of detecting up to a minimum of five copies is "incomprehensible" outside the "economic" context.

This viral suppression (sic) is often known as "undetectable viral load" or "being" undetectable.

Having an undetectable viral load does not mean that you are cured of HIV, nor does it mean that you should stop treatment. This means that, as long as the viral load remains undetectable, you significantly reduce your chances of transmitting HIV to someone.

This fact sheet is written for people living with the HIV virus. This topic is also covered byan information sheet written for people who do not have HIV(The link points to an automatic Google translation. I am ready to translate this properly and submit for review and publish until January 10 of two thousand and eighteen).

Viral load in different stages

During the first few weeks after contracting HIV the viral load is usually very high - usually several million viral copies per milliliter of blood (copies / ml). There is a considerable risk of transmitting HIV right now, and many people get HIV from someone who has recently contracted the virus, and in many cases, but not all, they do not know they are carriers.

After this early period of infection, the viral load generally decreases. A typical viral load in someone who is not on treatment may be 50.000 copies / ml. It is important to say that there is a risk of virus transmission even in this case.

 

"The viral load in blood and other body fluids is usually very similar - if HIV in your blood is undetectable, it is likely that it is undetectable elsewhere. "

 

When someone starts HIV treatment, the viral load usually becomes undetectable within six months. The risk of HIV transmission is greatly reduced when people have an undetectable viral load.

The evidence

In 2011, a large scientific trial called HPTN 052 found that treatment against HIV reduced the risk of transmitting the virus to a regular heterosexual partner by approximately 96%. The only reason it was not 100% is that a person on the test got HIV, but it happened only a few days before or after your partner started treatment.

 

A statement from the British HIV Association (BHIVA) and the AIDS Expert Advisory Group (EAGA) said that if the HIV-positive partner is on successful treatment, this is "as effective as consistent condom use" at limitation of transmission.

The statement emphasized that regular viral load testing is vital and it is advisable to wait six months after the first undetectable viral load test to make sure the treatment is working.

The BHIVA / EAGA statement applied only to vaginal sex because there were not enough homosexual couples in HPTN 052 to show whether HIV treatment reduced the risk to the same extent in relation to anal sex. In 2014, a study called PARTNER found no single transmission of HIV on 16.400 occasions of sex between gay men and 28.000 among heterosexuals, where the HIV-positive partner had a viral load lower than 200 copies / ml.

In 2015, a similar study exclusively on homosexual couples, Opposites Attract, also did not find transmissions of partners with an undetectable viral load. Both studies are collecting more data and will have final results in 2017.

What this means to me?

Many people with HIV see reducing infectivity and relieving anxiety about transmission as very important benefits of HIV treatment. You may want to take your viral load and your possible infectability into account when you think about safe sex. If you want to stop using condoms, it is important to discuss this carefully with your partners and ensure they are comfortable with the decision as well.

Discussing what an undetectable viral load means with HIV-negative partners can help reduce your anxiety about HIV transmission. But this information is likely to be new to most people who do not have HIV. It can take time for someone to understand and trust what you are saying. Knowing how HIV treatment can reduce the risk of transmitting the virus can be especially useful for people who wish to have a child.

Generating children

Serodiscordant couples may consider having unprotected sex on days when a woman is ovulating and on her most fertile date. It is important to remember that although HIV treatment protects your partners from the virus, you are not immune to other sexually transmitted infections ( ISTs):

  • Candidiasis
  • Boring
  • Condylomata Acuminado (Gallus Gland) - HPV
  • Gonorrhoea
  • Hepatitis C
  • Herpes
  • Syphilis

And so many, for example. In addition, in some countries, sex without a condom and without disclosing its HIV status is a criminal offense, regardless of the likelihood of transmission of the virus.

If I start HIV treatment, how quickly will my viral load become undetectable?

It may take six months or more and you should not rely on these writings to determine that:

"Ah ... I've been under treatment for 8 months and therefore, I'm undetectable, I can fuck without a condom without being dangerous." NOR THAT THE TUSCUS COW! First of all the result of the exam. And in the sequence, medical advice for you and your partner (s) !!!!!!!!!!! (I the publisher would never do that and I've been undetectable for so long that I can not remember right, but it was before the cake of chuchu do the lambança that he did with Every of AIDS and for years and years of this history)

Until then you can still be considered infectious.

It is a good idea for you and your partners to wait until your viral load has been undetectable for at least six months before making decisions about discontinuing condoms - or for them to stop using (!!!!! !!) to PrEP (pre-exposure prophylaxis).

Treatment of HIV always work?

About one in six people on their first HIV treatment regimen no longer have an undetectable viral load or their treatment stops working in the first year. During the second year of treatment, the chance of your therapy ceasing to work is about one in twenty and this further decreases in the next decade to about a chance of failure each year.

So the longer you've been on a specific HIV therapy, the less likely it will be to stop working. AND almost all reduce their viral load to an undetectable level in their second or third regimen. If someone's treatment does not result in an undetectable viral load, it is usually because they are having trouble following their prescribed treatment, ie they do not take the medication at the right time or shorten the dose (This is a generalization ) Treatments may simply fail because the person contracted HIV from someone whose virus, the viral strain in question, is already resistant to that treatment and may even be a case of cross-resistance)

.Do people with an undetectable viral load never transmit HIV?

It is difficult to prove that people with an undetectable viral load never transmit HIV. One study found that the lowest recorded viral load in someone who transmitted HIV was 362 copies / ml, although that person was not taking the treatment.

There were three transmission reports involving gay men who had an undetectable viral load near the time of transmission but we do not know if they had an undetectable viral load at the time the HIV was transmitted.

And I, the publisher, pause here. Is it worth the risk? We spent three decades trying to make people aware of the condom, almost without success, and now, WITHOUT HIM, did you release it? I publish here, it is my duty to inform. But I strongly advise against it because I know what I, euzinho, Claudio Souza, step and what I have seen human beings, people to be aware of being HIV carriers even though they are not "AIDS sufferers" only with peripheral neuropathy HIV. Think, think and think ... Is the viral load in the semen, the vaginal fluids, or the rectum no more important than the viral load in the blood?

Viral load in blood and other body fluids usually (!!!) is very similar - if HIV in your blood is undetectable, it is [[[[[[[[likely]]]]]]]] that it is undetectable elsewhere.

Occasionally (pal little word ... I contract HIV occasionally), people have undetectable HIV in their blood and have low levels of HIV in other body fluids but rarely at infectious levels (... how do you know? ...).

What about sexually transmitted infections (STIs)?

If you are not on the treatment, some STDs can make you more infectious: for example, syphilis can double your viral load. HIV-negative partners are also more likely to get HIV if they have an STD. However, in the study PARTNERS, there was no single transmission of HIV, although many people had STDs.

Gus Cairns, published in September of 2015

This document should be reviewed mid-2018

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