Does ART always work?

Usually yes.

Nearly everyone can get an undetectable viral load on ART. But some people ight take longer than others.

If your viral load stays detectable, it can be for one or more of the reasons below.

• Drug interactions. Some medicines, including supplements and vitamins, can affect how you ARVs work. Speak to your doctor and pharmacist about all medicines and supplements you take.
• Side effects. You have to be able to tolerate your meds and they have to be easy for you to take.
• Missing doses. This means checking you are taking the right dose at the right time each day. It might mean you are not following food recommendations.
• Drug resistance. Your HIV may have been resistant to one or more of the drugs you used. UK guidelines recommend a resistance test before starting treatment to check for this.
• Choice of drugs. Is the combination strong enough? Some combinations are not recommended with a viral load over 100,000 copies/mL. Also, the higher you start, the longer it may take to come down.
• Other reasons. Very rarely some people have a large reservoir of cells that are not reached by ART. So their treatment is working very but viral load is still detectable. This is a difficult situation to test for and even experts are unsure how it should be managed.

Most people though, if you have a good doctor and you take your drugs carefully, everyone starting ART should be able to get an undetectable viral load.

Last updated: 1 November 2024.