Q and A


Should I start ARVs if my viral load is low?


I have just discovered I have HIV. I think I got the infection about 3? ago and had a few days of primary infection, fever and red rash etc. My viral load is only around 650 and my CD4 is above 800. I am healthy otherwise.

Should I take the medicines or wait and see how it progresses? Can I be one of these elite controllers? They took another blood test to see what happens first.


Hi, how are you?

Can I ask how long ago you became HIV positive? Your question was not quite clear.

It is great that your viral load is low and shows that your body is managing well – especially as you still have a CD4 count in a healthy range.

While your body is dealing well, there are still benefits to taking treatment. At 650 your viral load is low, but it is not undetectable. Using treatment to get your viral load below 200 means there is no risk of you transmitting HIV to someone else. This is called U=U.

Also, if you are not being regularly tested, you will not know how your CD4 count is doing and it may be damaged without realising. Some people can take a while before HIV impacts their CD4 count falls, but without medication you will be waiting for this to happen.

It is possible you are an Elite Controller however this is very rare. There are also terms called Long-term slow progressors which is more likely. This means HIV will have an effect on your health but at a much slower rate than the general population.

How do you feel about taking medication for HIV?



  1. Josh Peasegood

    Hi Thread, it is not possible to know how your body will respond to HIV without medication.

    People live on HIV medication their entire lives. With newer medications there are far fewer long term side effects if any. For this reason, many people living with HIV have the same life expectancy as their HIV negative peers.

    HIV medication prevents active viral replication. This means the virus cannot ‘get bigger’ in the body while taking medication. It keeps HIV under control and prevents it having an impact over the body.

  2. Thread Starter

    Thank you for such a nice and quick answer.

    Sorry i meant i just tested positive last week for the first time, and i think i got infected 3 months ago. Is it possible viral load will drop soon naturally without medicine? Isnt 650 very very low for an early infection?

    I just turned 24, i am afraid of the medication long term side effects. Do these medications stop my ”sleeping” HIV reservoar from getting bigger incase of a future cure?


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