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 (i.e. be reactive).

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.

49 comments

  1. Lisa Thorley
  2. Noma

    Hi I recently found out my boyfriend is HIV positive and we have a baby together but both me and the baby are negative. He said he found out in College that he was positive and started taking treatment (ART) and from there has been testing negative.
    Could the negative results be from a undetectable viral load?

  3. Roy Trevelion

    Hi Bhaskar,

    Please see this link to what different tests are used to test for HIV.

  4. bhaskar

    tested non reactive ..took a rapid I guess 3rd gen test because the counsellor told me it’s an antibody only test.. @ AHF clinic .india
    exposure was 105 days ago..is it absolutely conclusive ?.
    thanks

  5. Roy Trevelion

    Hi steel fabrication,

    Thanks!

  6. steel fabrication

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  7. Roy Trevelion

    Hi Situs Poker Resmi,

    Thank you.

    i-Base provides timely and up to date information to people who are HIV positive and to healthcare workers.

    Info is evidence based and from clinical trials and observational studies.

  8. situs poker resmi

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  9. Roy Trevelion

    Hi TK,

    HIV treatment (ART) dramatically reduces your viral load. This gives the immune system the chance to recover. Not taking ART means that your immune system is in overdrive and producing more and more CD4 cells to try to cope. Unfortunately, over time if you’re not on ART your CD4 count will drop because your immune system becomes worn out.

    Here’s a guide to ART in Pictures. This explains what happens in detail and with pics.

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