{"id":4835,"date":"2025-01-01T12:00:40","date_gmt":"2025-01-01T12:00:40","guid":{"rendered":"http:\/\/i-base.info\/guides\/?page_id=4835"},"modified":"2025-01-12T22:21:33","modified_gmt":"2025-01-12T22:21:33","slug":"how-quickly","status":"publish","type":"page","link":"https:\/\/i-base.info\/guides\/changing\/how-quickly","title":{"rendered":"If your viral load never became undetectable…"},"content":{"rendered":"

\"\"<\/strong>How quickly should viral load become undetectable?<\/h2>\n

When you first start ART, viral load drops quickly.\u00a0It often becomes undetectable within a month. If not, then within three months. But sometimes this can take longer.<\/p>\n

The time it takes depends on several things.<\/p>\n

    \n
  1. Your viral load when you start.<\/strong> The higher this is, the longer it might take to come down.<\/li>\n
  2. Which HIV drugs you use.<\/strong> Combinations that include an integrase inhibitor reduce viral load faster than other types of HIV drugs.<\/li>\n
  3. Adherence.<\/strong> Drugs can only work if you take them. If you take your meds on time, viral load comes down more quickly.<\/li>\n<\/ol>\n

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

    If viral load is still high after three months, it is normal to change ART.<\/p>\n

    One exception<\/h2>\n

    However, there is one exception that is still not understood very well. <\/strong><\/p>\n

    In rare cases, it can take more than a year to become undetectable without needing to change treatment.<\/strong> This is if the low level viral load comes from a reservoir of sleeping cells. In this case the combination is not failing.<\/strong><\/p>\n

    This can happen if you are diagnosed very soon after infection. Also after starting treatment very early with a very high viral load.<\/p>\n

    However, your clinic can’t really test for these rare cases.<\/strong> It has to be interpreted based on very high adherence to a combination that really should work.<\/p>\n

    However, if your doctor added a new drug to you current combination and it makes no difference, this could be interpreted as the viral load coming from the reservoir. See the report below for more information.<\/p>\n