Test for opportunistic infections and CD4 cells. CD4 lymphocytes in HIV infection Does the number of cells decrease quickly in HIV?

Lymphocytes are a type of white blood cell. Lymphocytes make up approximately 15 to 40% of white blood cells. And they are one of the most important cells of the immune system because they protect you from viral infections, help other cells fight bacterial and fungal infections; produce antibodies, fight cancer, and coordinate the activities of other immune system cells.

The two main types of lymphocytes are B cells and T cells. B cells are created and mature in the bone marrow, while T cells are created in the bone marrow but mature in the thymus gland (the “T” stands for thymus). B cells produce antibodies. Antibodies help the body destroy abnormal cells and infecting organisms such as bacteria, viruses and fungi.

T cells are divided into three groups:

T helper cells(from English to help - “help”; also called T4 or CD4+ cells) help other cells destroy infecting organisms.

T-suppressors(from English to suppress - “suppress”; also called T8 or CD8+ cells) restrain the activity of other lymphocytes so that they do not destroy healthy tissue.

Killer T cells(from English to kill - “kill”; also called cytotoxic T lymphocytes or CTLs and are another type of T8 or CD8+ cells) recognize and destroy abnormal or infected cells.

“C” and “D” in CD4 stand for cluster of differentiation and denote a cluster of proteins that make up cell surface receptors. There are dozens of different types of clusters, but most often we talk about CD4 and CD8.

What is CD4 cell count?

T4 cells. CD4+ cells. T-helpers. Regardless of the name, if you are HIV positive, then these are the cells that are important to you (Note: when we talk about “T cells”, we will always refer to CD4 cells from now on). Knowing the number of CD4 cells in a person’s blood, which is determined Blood tests prescribed by your doctor can tell you how healthy your immune system is and how well it fights HIV. It is also useful to know your CD4 cell count when deciding when to start antiretroviral (ARV) therapy and whether to start taking medications for AIDS-related infections.

The job of CD4 cells is to “notify” other cells of the immune system that it is necessary to fight a particular infection in the body. They are also a major target of HIV, causing their numbers to decline over time. If there are too few CD4 cells, it means that the immune system is not working as it should.

The normal CD4 cell count is between 500 and 1,500 cells per cubic millimeter of blood (about a drop). In the absence of specific HIV treatment, CD4 cell counts decrease by an average of 50–100 cells each year. If the CD4 cell count is less than 200, a person may develop AIDS-related diseases (opportunistic infections), such as Pneumocystis pneumonia. And if their level drops below 50-100 cells, then a huge number of other infections can develop. For this reason, specific drugs to prevent these infections (prophylactic treatment) are started as soon as the CD4 count falls below a certain level, for example 200 in the case of Pneumocystis pneumonia.

When combined with a viral load test, your CD4 cell count can also help you decide when to start ART. Most experts agree that ARV treatment should be started immediately after diagnosis.

What is the CD4 lymphocyte fraction?

In the clinical laboratory test results form, you can see the column “proportion of CD4+ lymphocytes (%).” This indicator is of great importance to you and your doctor. In a healthy adult, CD4 cells make up 32% to 68% of the total lymphocytes, a large group of white blood cells that include CD4 cells, CD8 cells (see below), and B cells. Essentially, in the laboratory, the number of CD4 cells in a blood sample is determined by the proportion of CD4 cells.

Often, the CD4 cell count is more accurate than directly counting the CD4 count in a blood sample because it does not vary as much from test to test. For example, a person's CD4 cell count may vary from 200 to 300 over a period of several months, while the proportion of CD4 cells remains constant at, say, 21%. As long as the CD4 cell count remains at or above 21%, the immune system is functioning normally, regardless of the specific CD4 cell count. However, if the CD4 cell count does not exceed 13%, regardless of the specific CD4 cell count, it usually means that the immune system is damaged and it is time to start preventative treatment (disease prevention drugs) to prevent opportunistic infections such as Pneumocystis pneumonia .

What is CD8 cell count and T cell ratio?

CD8 cells, also called T8 cells, play an important role in fighting infections such as HIV. A healthy adult typically has between 150 and 1,000 CD8 cells per cubic millimeter of blood. Unlike CD4 cells, people living with HIV tend to have higher than average CD8 cells. Unfortunately, no one knows exactly why this happens. Therefore, the results of this analysis are rarely used when making treatment decisions.

Clinical laboratory test results may also indicate the T-cell ratio (CD4+/CD8+), that is, the number of CD4 cells divided by the number of CD8 cells. Because people living with HIV tend to have lower CD4 cell counts and typically higher CD8 cell counts, their ratio tends to be low. The normal ratio is usually between 0.9 and 6.0. So do CD8 cells. Some experts believe the inverse ratio in people living with HIV is a kind of double whammy from HIV. On the one hand, it promotes the death and turnover of T cells, which ultimately reduces the level of CD4 cells. On the other hand, because the virus causes the immune system to constantly fight inflammation, the CD8 cell count is chronically elevated. However, most experts agree that if the T-cell ratio increases (i.e., the CD4 count rises and the CD8 count drops) when you start ARV therapy, this is a clear sign that the drug treatment is working.

What do T-cell test results look like?

The absolute and percentage numbers of T cells are usually listed under "Lymphocyte Subset" or "T Cell Group". This is where the different lymphocytes in your body (CD3+, CD4+ and CD8+) as well as other immune cells are listed. This test is often called a complete blood count. Below is a sample standard T-cell test result form.

Definitions of some terms used in T-cell testing

Absolute CD3+ count

The CD3+ count is the total number of T cells, which are a type of white blood cell that matures in the thymus gland. These lymphocytes include T4 and T8 cells.

CD3 percentage

Total number of T lymphocytes (including T4 and T8 cells), expressed as a percentage of the total number of lymphocytes. These are white blood cells that mature and are found in the lymphoid organs of the body.

T4 cell count

The number of T4 cells per cubic millimeter of blood (that's about a drop). These are white blood cells that prime the immune system to fight disease and are also the main target of HIV. As HIV infection progresses, the number of T4 cells decreases from the normal value of 500-1500 cells to almost zero. When the T4 cell count drops below 200, it means there is an increased risk of developing opportunistic infections, and when the count drops below 50, the risk increases sharply.

T4 percentage

The number of T lymphocytes expressed as a percentage of the total number of lymphocytes. These are white blood cells that mature and are found in the lymphoid organs of the body. Often the percentage of T4 cells is more accurate than the T4 cell count directly because it does not vary as much from test to test.

T8 cell count

The number of T8 cells per cubic millimeter of blood (that's about a drop). Although most test forms call them suppressors, they actually include both suppressors and killer T cells (see definitions above). T8 cell counts tend to be elevated in people with HIV, but because little is known about why this is the case, these test results are rarely used when making treatment decisions.

T8 percentage

The number of T8 lymphocytes expressed as a percentage of the total number of lymphocytes. These are white blood cells that mature and are found in the lymphoid organs of the body. Often the percentage of T8 cells is more accurate than the T8 cell count directly because it does not vary as much from test to test.

T cell ratio

The number of T4 cells divided by the number of T8 cells. Because the number of T4 cells in people living with HIV is usually lower than usual, and the number of T8 cells is usually higher, the ratio of the two is usually lower than usual. The normal ratio is usually between 0.9 and 6.0. As with T8 cells, no one knows exactly what a low value means. However, most experts agree that if the T-cell ratio increases with the start of ARV therapy (ie, the number of T4 lymphocytes increases and the number of T8 lymphocytes falls), then this is a clear sign that the drug treatment is working.

Doctors use two types of tests to assess how HIV affects your health: Your CD4 cell count shows how strong your immune system is. A viral load test measures the amount of HIV virus in your blood.

Regular monitoring (checking) of CD4 cell count and viral load is a good indicator of how HIV is affecting the human body. Doctors interpret test results in the context of what they know about HIV patterns.

For example, the risk of developing opportunistic infections is directly related to the number of CD4 cells. Your viral load can predict how quickly your CD4 levels might drop. When these two results are taken together, you can predict how high your risk of developing AIDS will be in the next few years.

The results of CD4 cell count and viral load tests will help you and your doctor decide when to start ARV (Anti-RetroViral) therapy or treatment to prevent the development of opportunistic diseases.

CD4 cells, sometimes called T helper cells, are white blood cells responsible for the body's immune response to bacterial, fungal and viral infections.

CD4 cell count in people without HIV

The normal number of CD-4 cells in an HIV-negative man is from 400 to 1600 per cubic millimeter of blood. The number of CD-4 cells in an HIV-negative woman is usually slightly higher - from 500 to 1600. Even if a person does not have HIV, the number of CD-4 cells in his body depends on many factors.

For example, it is known that:

• Women have higher CD4 levels than men (by about 100 units);
• Level 4 in women may fluctuate depending on the phase of the menstrual cycle;
• Oral contraceptives may reduce CD-4 levels in women;
• Smokers typically have lower CD-4 cell counts than nonsmokers (by about 140 units);
• The CD-4 level drops after rest - fluctuations can be within 40%;
• After a good night's sleep, your CD4 count may drop significantly in the morning but rise during the day.

None of these factors appear to affect the immune system's ability to fight infections. Only a small number of CD-4 cells are found in the blood. The rest are in the lymph nodes and body tissues; Therefore, the listed fluctuations can be explained by the movement of CD-4 cells between the blood and body tissues.

CD-4 cell count in HIV-infected people

After infection, the CD-4 level drops sharply and then settles at 500-600 cells. People whose CD-4 levels initially fall faster and stabilize at a lower level than others are thought to be more likely to develop HIV infection more quickly.

Even when a person does not have obvious symptoms of HIV, millions of his CD-4 cells become infected and die every day, while other millions are produced by the body and rise to protect the body.

It is estimated that without treatment, the CD4 cell count of an HIV-positive person falls by about 45 cells every six months, with greater loss of CD4 cells seen in people with higher CD4 counts. When the CD4 cell count reaches 200-500, it means that the person's immune system has suffered some damage. A sharp drop in the CD4 count occurs about a year before the onset of AIDS, which is why it is necessary to regularly monitor the CD4 level from the moment it reaches 350. The CD4 level will also help decide whether to take medications to prevent certain diseases associated with the stage of AIDS.

For example, if your CD4 cell count is below 200, it is recommended to take antibiotics to prevent infectious pneumonia.

CD4 can fluctuate, so don't pay too much attention to the result of one test. It is better to pay attention to the trend in the CD4 cell count. If a person's CD4 count is high, they have no symptoms, and they are not on ART, they likely need to have their CD4 cell count checked every few months. But if a person's CD4 count drops sharply, if they are participating in clinical trials of new medications, or taking ART, then they should test their CD4 cell count more often.

CD4 cell count

Sometimes doctors not only look at the nominal CD4 cell count, but also determine what percentage of all white blood cells are CD4 cells. This is called a CD4 cell percentage test. The normal result of such a test in a person with an intact immune system is about 40%, and the percentage of CD4 cells below 20% means the same risk of developing a disease associated with the stage of AIDS.

CD4 level and ARV therapy

CD4 can serve to determine the need to start ARV therapy and as an indicator of how effective it is. When the CD4 cell count drops to 350, the doctor should help the person determine whether he or she needs to start ART. Doctors recommend that a person start ARV therapy when the CD4 count drops to 250-200 cells. This level of CD4 cells means that a person is in real danger of developing AIDS, an associated disease. It is also believed that if you start ARV therapy when the CD4 count has dropped below 200, then the person will respond less well to treatment. But at the same time, it is known that there is no benefit from starting therapy when the CD-4 cell count is above 350.

When a person starts taking ARV therapy, their CD4 count should begin to slowly increase. If the results of several tests show that the CD4 level is still falling, this should alert the doctor and inform him that it is necessary to reconsider the form of ARV therapy.

This is a train that takes a person from the starting station - the moment of infection to the final station - the stage of AIDS. Immune status is the remaining distance to the final station. Viral load is the speed of a train. Therapy is a stop valve that stops the train and turns it back on. But if you pull the stop valve too late and at high speed, then the inertia of the train will no longer allow you to effectively brake it and engage reverse.

Immune status- This:

1. General condition of the immune system (e.g. “low SI”, “high SI”)
2. A special blood test to assess the state of the immune system (for example, “donate blood for I.S.”).

Immunodeficiency is a reduced immune status.

Why is immune status determined?

CD4 cell

An immune status test determines the number of different cells of the immune system. For people with HIV, the number of CD 4 cells (or T 4 lymphocytes) matters.

CD 4 or T 4 lymphocytes are white blood cells that are responsible for “recognizing” various pathogenic bacteria, viruses and fungi, which the immune system must destroy.

Information about the number of CD 4 cells allows the doctor to assess the level of health of the immune system, whether it is worsening or improving. The word "status" means state.

Respectively, the more of them, the better.

How is immune status measured?

Another CD4 cell

Immune status is measured using a special analyzer and is expressed as the absolute number of CD 4 cells in one microliter of blood (that is, not in the entire body). It is usually written as "cells/μl" or "μl -1".

In addition, the doctor can estimate the percentage that CD 4 makes up of the total number of white cells. This is the percentage (relative) number of CD 4 cells. Its normal value is 30-60%.

Why might immune status change over time?

HIV can infect CD 4 and make copies of itself in them, causing these cells to die. Although cells are killed by HIV every day, millions of CD 4s are produced to replace them. However, over a long period of time (years), the CD 4 count may decrease and even drop to dangerous levels. For most people with HIV, the CD 4 count usually declines over a period of years.

What does this or that number of CD 4 cells mean?

• from 500 to 1200 cells/μl is normal.
• from 350 to 500 cells/μl indicates a reduced functioning of the immune system (moderate immunodeficiency).
• from 200 to 350 cells/μl or begins to decline rapidly (severe immunodeficiency) is a reason to talk to your doctor about prescribing antiretroviral therapy.
• less than 200 cells/μl (profound immunodeficiency) - initiation of therapy is recommended, since with such an immune status there is a risk of AIDS-associated diseases.

What determines the number of CD4 cells?

The CD 4 cell count can rise and fall as a result of infections, stress, smoking, exercise, the menstrual cycle, birth control pills, time of day, and even the time of year.

CD4 count(full name: CD4+ T-cell count, or CD4+ T-cell count, or T4, or immune status) is a blood test result that shows how many of these cells are contained in a cubic millimeter of blood.

The CD4 count is a very good surrogate marker. It indicates how strongly HIV has affected the immune system, what is the depth of the infectious process, what is the risk of other infections, and when it is necessary to start treatment. The average CD4 cell count for an HIV-negative person ranges from 600 to 1900 cells/ml of blood, although some people may have higher or lower levels.

2-3 weeks after infection, the CD4 count usually falls.

As the immune system begins to fight back, the CD4 count rises again, although not to baseline levels.

Over the years, the CD4 count gradually decreases. The average annual decline in CD4 count is about 50 cells/mm3. For each individual person, this rate is individual, depends on many factors, such as the subtype of the virus, the person’s age, the route of HIV transmission, genetic characteristics (presence or absence of CCR5 receptors) and can be higher or lower.

Most people's immune systems successfully control HIV without requiring treatment for many years.

CD4+ cell count is a blood test that determines how well the immune system is functioning in people with the human immunodeficiency virus (HIV). CD4+ cells are a type of white blood cell. White blood cells play an important role in the fight against infections. CD4+ cells are also called T lymphocytes, T cells, or T helper cells.

HIV attacks CD4+ cells. The CD4+ cell count helps determine whether other infections (opportunistic infections) may occur. The CD4+ cell count trend is more important than the value of a single test because the data can change from day to day. The trend in CD4+ cell count over time demonstrates the impact of the virus on the immune system. In untreated HIV-infected people, the CD4+ cell count usually declines as HIV progresses. A low CD4+ cell count often indicates a weakened immune system and a higher chance of developing opportunistic infections.

Why testing is done

The CD4+ cell count is measured to:

Observing how HIV infection attacks your immune system.

Help to make a timely diagnosis of acquired immunodeficiency syndrome (AIDS). HIV leads to AIDS, a long-term chronic disease for which there is no cure.

Determining when it is best to start antiretroviral therapy, which will reduce the rate of development of HIV infection in the body. For more detailed information, please refer to the “Results” section.

Determining your risk of developing other infections (opportunistic infections).

Determining when is the best time to start preventative treatment for opportunistic infections, such as taking medications to prevent Pneumocystis pneumonia (PCP).

The CD4+ cell count measured when you are diagnosed with HIV serves as the reference point against which all subsequent CD4+ cell counts will be compared. Your CD4+ cell count will be measured every 3 to 6 months, depending on your health, your previous CD4+ cell count, and whether you are taking highly active antiretroviral therapy (HAART).

How to prepare for the test

Before taking this test, consult a professional who can advise you on the meaning of the test results. Find out how this test relates to your HIV infection.

How the test is carried out

The healthcare professional performing the blood draw will do the following:

Place an elastic bandage around your arm above the elbow to stop blood flow. This enlarges the veins that are below the level of the bandage, making it easier for the needle to enter the vein.

Wipe the needle with alcohol.

Inserts a needle into a vein. It may take more than one try.

Attach a blood collection tube to the needle.

When the required amount of blood has collected, he will remove the bandage from your arm.

Apply a gauze compress or cotton swab to the site where the needle punctures the skin after removing it.

First, he will apply pressure to the puncture site, and then apply a bandage.

How will it feel

You may not feel anything during the injection, or you may feel slight pain as the needle passes through the skin. Some people experience a burning pain while the needle is in the vein. However, most people experience no or minimal discomfort when the needle is inserted into a vein. How much pain you experience will depend on the skill of the healthcare professional who takes the blood sample, as well as the condition of your veins and your sensitivity to pain.

In the time since the discovery of the human immunodeficiency virus, serious progress has been made in treatment. But until now, those infected and their loved ones are interested in the viral load of HIV, its indicators and the norm. These data are taken into account when selecting therapeutic methods that extend years. In the absence of treatment, doctors predict up to 10 years of life for people with HIV; with properly selected treatment - up to 70. Not the least important place in such a study is occupied not only by antibodies to HIV infection, but also by the number of cells responsible for immunity, T-lymphocytes, or CD-4 - they are the ones who can protect the infected person from concomitant diseases leading to mortality or AIDS. A general blood test, also prescribed for HIV, helps to clarify the situation. If the level of antibodies to the virus is low, it is enough to undergo examination twice a year; if increased during pregnancy, taking rotating groups of antiretroviral drugs - once every 2-4 weeks - 3 months.

• Diagnostics
  • Polymerase chain reaction
  • Immunoblotting
• Norms
• What is immune status
• Immune status and virus

Blood tests for human immunodeficiency virus

The study of biological material, which is blood, remains the most informative method. Before taking an HIV test, they try to take into account the behavior of the virus. It manifests itself in plasma, although it is found in seminal fluid and vaginal mucus. HIV testing is a multicomponent diagnosis. Blood is taken for various studies:

1. Blood test for HIV. Often the virus is first detected when taking a blood test for HIV and hepatitis.
2. A general blood test is also prescribed for HIV. It will show specific indicators of leukocytes, platelets, hemoglobin, erythrocyte sedimentation rate (ESR). But these same nuances sometimes indicate other viral infections; in case of deviation from the norm, other blood tests are prescribed.

Important! If you don’t know how HIV tests are done, on an empty stomach or not, doctors will answer: biological material is collected on an empty stomach. This ensures reliable results.

1. Rapid tests for HIV. They give results within 30 minutes. They study not only blood, but also saliva and urine. The test is informative in terms of diagnosing infection and the number of antibodies. Sometimes it happens that the test for HIV is positive, but the analysis is negative. The result is false negative if the infection occurred recently. You will need to undergo this examination in 6 weeks.
2. Enzyme immunoassay. Serum is isolated from the blood, where antibodies to the human immunodeficiency virus are looked for. When patients ask how long it takes to test for HIV, doctors answer: up to 10 days. But even here the possibility of erroneous results remains. This is affected by autoimmune diseases, exacerbations of chronic diseases, and cancer.

When wondering where you can get tested for HIV, you should contact a private laboratory, AIDS and HIV prevention and control centers, but the easiest way is to donate blood at a public clinic at your place of residence. Anonymity remains a positive aspect of every medical institution.

You can find out how much your AIDS test costs in advance. The price for HIV analysis ranges from 300 to 12,000 rubles. Research in private laboratories and highly sensitive tests remain more expensive.

Diagnostics

Conventionally, diagnostic studies are divided into 2 types. The first group helps determine the fact of infection. Such tests can establish control over the course of the infection and indicate the effectiveness of treatment.

The second group determines antibodies to the human immunodeficiency virus, p24 antigen (serological tests) and viral RNA, provirus DNA (molecular genetic tests).

A detailed diagnosis is prescribed after a general blood test has been performed, which is advisable to do in case of HIV. HIV infection occurs in different stages: from an asymptomatic state to an acute phase, like AIDS. During it, the body suffers from opportunistic diseases, while the immunity of healthy people can resist them. This will be demonstrated by general blood cell counts.

Diagnostics helps to determine the number of leukocytes. Future treatment and quality of life also depend on the ratio of them and antibodies to the virus. In addition to general methods, specific techniques are also used.

Polymerase chain reaction

This is one of the most effective methods for diagnosing infection. Its results are 90–99% true: the test does not detect antibodies to the virus, but its RNA. This HIV test has a short readiness time - up to 3 days.

Immunoblotting

This is a highly sensitive and not the cheapest method for recognizing a viral infection. It involves separating the viral proteins, after which they are transferred to a nitrocellulose membrane. After the electrophoresis procedure, its antigens, which differ in molecular weight, are compared with the samples on the test strip. The method shows at what stage of immunodeficiency a person is.

Norms

In a healthy person, the CD-4 immune index is 400-500 – 1600 cells/ml. If the number decreases to 200-500, changing every six months by 45 units, there is a high probability of infection. But the possibility of diseases affecting immune processes, pregnancy and breastfeeding in women is also taken into account.

Also, a blood test for HIV has standards for infected people. If the cell count drops to 350, it’s time to start therapy. Thanks to this, concomitant diseases that are dangerous for infected people will not develop.

If the number has dropped to 200 units, highly active antiretroviral therapy is often prescribed. Those suffering from immunodeficiency are advised to get tested for HIV and hepatitis. Liver diseases often accompany a dangerous virus and aggravate the immune system.

Important! Half of the cases of infection are diagnosed after a blood test has been performed for hepatitis, rw and HIV: after a woman registers for pregnancy, during medical examinations, before donating blood.

Those infected are interested not only in the value of CD-4. The number of dangerous virus particles in the blood plasma is important. The load may show an erroneous result due to violation of test conditions, after vaccinations, or due to previous diseases. This also applies to healthy people. But if after a month the indicator increases by 3-5 times, this is a reason to think about it.

Much depends on the health status of the infected person. It is characterized by blood cells, in particular, those responsible for fighting foreign bodies, including viral infections.

What is immune status

The set of quantitative and qualitative indicators of immunity is the immune status. It is better to measure it at the same time of day, in the same laboratory, using the same tests. The difference between them sometimes leads to false results.

Immune status and virus

The condition of an infected person depends on the ratio of the main indicators: the number of virus particles and CD-4 cells, immune status and viral load - mandatory parameters for diagnosis and possible treatment. The task of doctors is to increase the immune status that fights the virus. However, it is capable of infecting CD-4 cells, their number can sharply decrease to a critical level. That is why the patient is periodically diagnosed.

Results and interpretation of analyzes

Enzyme immunoassay results may vary. They identify different protein compounds present in the virus envelopes. The sets of proteins in test systems may differ, but if 3 main ones are detected, the test will give a positive result.

Scientists identify the following indicators:

• Up to 20 thousand copies/ml – insufficient RNA concentration. This is a good result for an infected person. In a healthy person, the indicator should be zero.
• From 20 thousand to 100 thousand – the middle stage, characterized by primary or secondary manifestations of immunodeficiency.
• From 100 thousand to 450 thousand is considered a deadly indicator. The higher the number, the greater the likelihood of developing AIDS.

Important! You can donate blood again if you have a false negative, false positive or incorrect result. A negative result is true if there is no risk of infection in the 12 weeks before blood collection.

Routes of transmission of viral infection

The cost of an HIV test makes it accessible to everyone. The relevance of the problem is confirmed by common methods of transmission of infection: the use of unsterile medical instruments, in particular syringes, the route from mother to child, during unprotected sexual intercourse, and through blood transfusion.

When asked how long after a possible infection can be tested for HIV, doctors answer: you need to wait from 3 weeks to 3-5 months.

What to do for infected people and their loved ones:

1. Monitor the number of RNA copies of the HIV virus. This reduces the risk of maternal infection of the fetus and also increases the life expectancy of the infected person.
2. Get tested in a timely manner and responsibly take courses of antiretroviral therapy.
3. Remember that not only the determination of the viral load for HIV is important indicators, their correlation with the results of the immune status is the main component of treatment. Tests are taken regularly.

Since there is no cure for the HIV virus, people with a viral load need to ensure that the number of viral particles does not go beyond the normal range. Even with this diagnosis, you can continue to live a full life.