Final answer:
The viral load in an HIV positive patient initially increases, decreases due to immune response, remains low during clinical latency, and then increases again as the individual progresses towards AIDS.
Step-by-step explanation:
The correct answer to the student's question is b - the viral load in a patient who is HIV positive initially increases, then decreases, and then increases until the patient develops AIDS. During the acute HIV infection stage, there is rapid replication of the virus, resulting in a high viral load. The immune response kicks in, causing both an increase in killer T cells and the production of antibodies, which leads to a short-term decrease in the viral load. Following this, the virus enters a clinical latency stage, where the virus reproduces at low levels.
In the latent stage, particularly in patients not on antiretroviral therapy, HIV remains active but with a low replication rate, often showing no symptoms. This stage can last a long time, from a decade up to several decades if receiving treatment. As time passes, the virus gradually increases the rate of replication, the viral load rises, and the CD4 T-cell count falls, marking the progression towards AIDS. At this stage, the patient becomes more susceptible to opportunistic infections due to a weakened immune system and eventually progresses to AIDS when the CD4 T-cell count drops below 200 cells/μL, or the patient develops certain opportunistic illnesses, indicating significant immune compromise.