Does a person with high viral load look healthy?

A high viral load indicates a rapid rate of multiplication of HIV. In the usual course, a high viral load corresponds to a low CD4 count. This is because more number of viruses in the blood means greater destruction of CD4 cells. However, it can happen that the viral load is high but the CD4 count is not very low. A high viral load does not directly affect a person. It is decrease in CD4 cells that causes the individual to fall ill. Decreased immunity makes a person ill in more ways than just contracting infection. A person with a high viral load may appear healthy until their CD4 count falls below a critical level. That is the point at which they start to be unwell.