Q and A

Question

Will someone always test HIV positive – even with an undetectable viral load? – updated answer!

If you have achieved undetectable level and have been so for a period of say 6 months, and then were to have an HIV test at another clinic where they don’t know your positive status, would the test come back as negative because you are undetectable or would it still be reactive?

Answer

For nearly everyone, the HIV tests will still be HIV positive.

This is because HIV tests look for an immune response (called an antibody).

Even if there was an HIV cure – and this might be found one day – your antibody response is always likely to test HIV positive.

Some HIV negative people in early HIV vaccine trials, test HIV positive on an antibody test because of their immune response, even though they do not have HIV infection.

An exceptions if for people who start HIV treatment (ART) within a few weeks or months of their infection. After being on ART for several years, people who used very early treatment, can sometimes test HIV negative with “rapid” HIV tests.

This report includes details of a recent study reporting this:
http://i-base.info/htb/32657

Treating HIV even earlier – within days of infection – means that some HIV positive people never test positive on an HIV antigen test. This is even though viral load (RNA and DNA) has shown they are positive. A study in Bangkok was able to diagnose some gay men in very early infection. Immediate ART meant that many of these people never tested HIV positive – until they had a treatment interruption as part of a cure study.
http://www.croiconference.org/sessions/hiv-rna-rebound-postinterruption-persons-suppressed-fiebig-i-acute-hiv

Cases of sero-reversion (HIV positive people who later test negative) have also been reported for some babies treated immediately after birth.
http://programme.aids2018.org/Abstract/Abstract/12202

This answer was updated in August 2018 and December 2017 from a Q&A first posted in June 2001.

37 comments

  1. Lisa Thorley

    Hi Bright,

    Please read the updated post above.

  2. Bright

    Good day.If you are on ART and viral load undetected.If you go for medical and want to get job will it show negative result when the doctor is not informed of status

  3. Lisa Thorley

    Hi Christopher.

    At the moment injectable ARVs aren’t on the market, there are however people working on these. As to when they’ll be available its not possible to say. However, please see the following:
    http://i-base.info/qa/14069

  4. Christopher

    Where can I find injectable ARVs?

  5. Roy Trevelion

    Hi Thaka,
    If you forget your meds you should take them as soon as you remember. But if it’s close to the time for your next dose you shouldn’t take two doses together.
    It sometimes happens to all of us that we’re late taking meds. But giving your child NVP syrup an hour late shouldn’t be a problem, as long as it doesn’t happen too often.

  6. Thaka

    I’m HIV positive and breastfeeding if I forget to my ARVs for one day and take two the following day on separate times will this put my child at risk of getting infected,and the other day a switched off the alarm and remembered an hour later that I have not given her Nvp syrup will this expose my child to HIV

  7. Roy Trevelion

    Hi Grace,
    It’s very unusual to have an undetectable viral load without HIV treatment (ART). But a very small proportion of HIV positive people have undetectable viral loads below 50 copies/mL for years without taking ARVs. They’re known as elite controllers.

    But there is some concern that HIV might be damaging different parts of the body, even with this low level in the blood. Please see this link for more info. It sounds like you’re doing very well. But it’s a good idea to talk to your doctor about monitoring your health. You can discuss whether to start ART for you as an individual.

Comment

Your email address will not be published. Required fields are marked *