If a person has HIV what does the viral load test mean? Is there any real link to overall health or immunity?

A friend goes on and off his meds regularly and his viral load changes but he says he feels no different. This person is not sexually acvtive.

I searched the internet and all the answers were the same with little in the way of research

I do HIV education and testing. The viral load test is a measurement of the amount of HIV in the blood ( High viral load means there is more of the virus in the blood.) Although the viral load can be linked to overall health or immunity, a better indicator is a Tcell or CD4 count. The Tcells (or CD 4 cells) are associated with the immune system. HIV damages the immune system by destroying the CD 4 cells. A low CD4 count indicates a poor immune system. People with low CD4 counts have extreme difficulty fighting infections such as colds, flu, and pneumonia. Because people react differently to illnesses (including HIV), some people may be able to maintain a good CD4 count with a high viral load, while other people may have a very low CD 4 count, even with a low viral load.
Normally, when the CD4 count goes to 200 or below, the diagnosis changes from HIV+ to full-blown AIDS.
Your friend should follow his doctor's instructions regarding taking his meds. With treatment, many HIV+ people are living longer, healthier lives. The meds can't cure HIV at this point, but they can increase the amount of time between the diagnosis of HIV and the diagnosis of AIDS.

A higher viral load indicates a few things:
-greater chance the disease progression will be faster (the more virus the more damage that can be done)
-if your friend is interupting his treatments, there is a higher chance of developing resistance to the meds

-having a high viral load does not, necessarily, cause symptoms, so your friend is most likely telling you the truth. However, with HIV, you cannot rely on symptoms as an indicator of how well a person is doing. Lab tests (CD4 count/percentages and viral load testing are needed).

There is some very new data reported recently at a major conference in Boston (CROI) that indicated that structured treatment interruptions have a negative effect in the long run.