Question
Will someone always test HIV positive – even with an undetectable viral load? – updated answer!
5 September 2018. Related: All topics, CD4 and viral load.
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 study reporting very early ART and several years of viral suppression can result in testing HIV negative using rapid HIV tests.
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.
Cases of sero-reversion (HIV positive people who later test negative) have also been reported for some babies treated immediately after birth.
This answer was updated in August 2018 and December 2017 from a Q&A first posted in June 2001.
Hi i tested positive in 1998 while pregnant and after giving birth i sent my son for Hiv tests but he tested negative . my viral CD4 count fluctuates but i have never been on ARVs since, The father of my son also tested negative. I did test 2 weeks back and my viral load is 35 while CD4 count is 550 , should i start with ARVs or should i wait? Remember i hsve never been on ARVs since 1998.
Hi Mandy,
As long as your viral is undetectable then there isn’t any risk. Please see Q’s 9 and 14 here: https://i-base.info/qa/what-are-the-most-asked-questions If your viral load is detectable, which is shouldn’t be due to you being on meds for a year, then yes there would be a risk. If your partner is aware of your status then this is a risk that is his to take.
Hi I have been on treatment since last year.so I had sex with my boyfriend first round nd second we used condom last one he refused to use condom so we had unprotected sex is he on a high risk of getting HIV though he circumcised?
Hi Zeenor,
Has your child been on medication? Do you know what your sons CD4 count is as well as viral load? The test that they had, was this actually a HIV test?
My child was diagnosed with HIV 2008 but the test now came back negative
Hi Deniz,
Thanks for your questions.
1. Yes, tests are done to help find out the right medication before starting HIV treatment (ART). Can you call the clinic and ask for the results?
2. Once you start ART you can expect to get to undetectable after a few months. Most people reach undetectabke within the first three months. But even when you’re undetectable your HIV test will still be positive.
Being HIV positive shouldn’t be a reason to refuse an operation. But you can read more info on this question about HIV treatment and hormones for trans* women that is answered here. Do you have support for seeking surgery and transitioning? CliniQ is sexual health and well-being service for trans people in the UK. This is an NHS clinic that was created by and for trans people. They are a great resource if you want further support and information.
CliniQ website:
http://www.cliniq.org.uk
hi . I got 2 questions
1. I have done the tests to find out the right.medication for me. it has been 3 months now and I still didn’t get the results and didn’t start treatment yet is it normal?
2. after been undetectable if I go to hospital to have an see surgery mail to female with it be noticed I’m possitive? will I be refused operation if so? looking for answers I’m so scared.
Hi Bongiz,
Sorry that you’re feeling ill. But how has your treatment gone over the years? Do you know your CD4 count and viral load. Sometimes the clinic will change a pill and it can look different but it can still contain the same drugs. But you can call the clinic and ask if they’ve changed it or if it just comes from a different company. Perhaps you can make a list of your symptoms for the clinic too.
I am HIV positive I’ve started receiving my treatment 2012 now I am feeling very I’ll all the time and am getting one pill the pinkish one but now they giving me the white one at the clinic and now I am feeling very ill but they told me that it is the same pill. Plzzz help I am scared now.
Thank you for making it easier for us all through this tough time and situation of living with HIV.