Question
Will HIV tests be positive if viral load is undetectable?
26 September 2017. Related: All topics, CD4 and viral load, HIV testing, South Africa.
If my viral load is undetectable and I do an HIV test, will it show a positive result?
Answer
Hi
Viral load tests look for how much virus can be found in a sample of blood.
HIV tests looks for whether your immune system has ever been in contact with HIV.
As immune responses stay with you for life, even when there is no detectable viral load, the HIV test should always be positive.
Even if an HIV cure is found, the HIV antibody test is likely to still be positive for most people.
However, sometimes people who start ART very soon after infection, might test negative with rapid HIV tests. This is a test problem, thoough – the person still has HIV. Please see this report for details.
Modern HIV tests are very accurate, so it’s extremely unlikely to be a false positive result. Your test result will be unaffected by other things such as a cold or flu. Your doctor will use your viral load and CD4 test to discuss treatment with you. HIV treatment today is safe and effective and will help you to stay healthy.
I need advice. I’ve already got my HIV result. And it’s positive with HIV antibody only. Does it mean that I’m already infected? My doctor has already asked me to have a re-test done with viral load and CD4. Does it mean that it could lead to false positive result?
Hi,
You should double check with your doctor or clinic but these sound as if they mean the same thing.
But sometimes viral load tests can give two similar sounding results.
If the test cut-out for example is Less than 50 copies/mL, the result is given as undetectable. This also means that the test can’t measure any number less than 50 copies/mL.
Sometimes there is a second result that is not a number but just significes whether any positive activity was seen below this level. The result is either detected or not detected.
Once you are below 50 copies/ml there doesn’t seen to be any clinical benefit from the activity being detected or not detected, but this might explain the two results.
I would like to know the difference, if any, between undetected and not detected viral load results.
Hi,
This is confusing. If you have an undetectable viral load you do not have resistance, at least to the drugs you are on at the moment. You should talk to you doctor or clinic about this. It is important to clear up. This also because with certain meds and certain resistances staying on the medication can make it worse. I would ask to clarify what is going on.
2016/
I was diagnosed HIV Positive about 5 years ago.At the time I was tested I was seriously ill as I was just diagnosed with Bipolar mood disorder and admitted at the psychiatric hospital. I started with the ARV treatment immediately. Few months later I got sick and was hospitalised. I was told that the HIV was undetected and the reason why I got sick was that my body is resistant to the treatment. But since I had started with the treatment I should continue with it anyway. I’m a bit confused.
Hi,
It is not the case that rapid tests would come back negative for someone with an undetectable viral load. This is because rapid tests test for HIV antibodies not the virus itself. Antibodies are a body’s response to the virus.
My partner is HIV positive undetectable and I am negative and on PrEP. We were both under the impression that due to his undetectable status that the rapid test would not be able to be picked up. But as i have access to rapid tests , i was able to test us both at the same time , I am still negative and his one was positive, even though he is undetectable.
Hi Jake, I can’t comment on the response rates for the test you used without more details, but all tests will include a small chance of either false positive or false negative results. These rates are higher using many of the rapid tests including home sampling tests, compared to laboratory tests. This may explain your results. In general, HIV antibody tests should continue to test positive even when viral load is undetectable. In theory, someone might start treatment who does not have HIV, but I’ve only heard of one such case where the original HIV test confirmed. If your medical history definitely included HIV infection because of viral load results, then this is most likely a test or sampling error. Please ask your clinic about this when you next have an appointment.It would also be reasonable to ask the manufacturer how often this happened in the original studies.
I’m confused by this response. I have an undetectable viral load and a strong CD4 (1200). I’ve been on Atripla for three years after I was diagnosed three months after infection. I did a home HIV blood test about two months ago and it did not show a positive result. I am certain I did it correctly as my friend did one with me and his showed up positive. I did the test with him for moral support and help him through this difficult time as i have been there. According to your response my test should have been HIV positive.