If your viral load never became undetectable…

How quickly should viral load become undetectable?

When you first start treatment, viral load drops quickly.

Many people become undetectable within the first month and most within three months. Some people take longer.

The time it takes to get undetectable depends on several things:

  • Your viral load when you start. The higher it is, the longer it will take.
  • Which HIV drugs you use. Integrase inhibitors reduce viral load faster than other meds.
  • Adherence. Drugs can only work if you take them. If you take your meds on time, viral load comes down more quickly.

Viral load should drop by at least 90% in the first month. This is sometimes referred to as 1 log (see Table 1 below). If not, your doctor will ask you about adherence and may take other tests.

If viral load is still detectable after 3-6 months, it is normal to change treatment.

What is second-line treatment?

Second-line is the name for your second combination.

If this second treatment fails, your next treatment is called third-line.

How long should I wait?

This will depend on your individual situation.

It will depend on why treatment might not be working and on the results of other tests.

Table 1: Log scales (a log 10 scale is a multiple of a factor of 10).

1 log = 10 1.5 log = 30 1.7 log = 50
2 log = 100 2.5 log = 300 2.7 log = 500
3 log = 1,000 3.5 log = 3,000 3.7 log = 5,000
4 log = 10,000 4.5 log = 30,000 4.7 log = 50,000

Last updated: 1 January 2018.