Question
Is my parter at risk when I have a viral load of 70?
5 September 2023. Related: All topics, CD4 and viral load, HIV transmission.
Hello, I am from the Philippines. I have recently started dating again after receiving my first undetected VL result last June 2023 (70 copies – we use the less than 200 guideline here). My CD4 is 190+, with the trend going up from the first three CD4 tests. I’m starting to see someone, and we had sex already (with condoms). Is there still a risk of transmission? I have been adherent with my ARVs ever since I was diagnosed last June 2022.
My ARVs are Teno-Lami-Dolu (TLD) and was switched up to Teno-Lami-Efav (TLE) last June as well due to supply issues with the clinic. Is there a possible time window that I might have had a detectable viral load during the switch?
During intercourse, I bled as I was on the receptive end, but there were no issues with the condom. Is there a presentable risk in such a situation? We also participated in deep kissing, where I might have bled once or twice.
Lots of support, all the love from the PLHIVs here in the Philippines.
Answer
Hi, how are you doing?
It is great to hear how well you are doing on treatment.
A viral load of 70 is excellent. This is considered undetectable and means U=U does apply. There is no risk of transmission to your partner. Even without using a condom it is not possible to pass on HIV.
Switching from TLE to TLD will not risk your viral load becoming detectable. As your viral load had already been suppressed, switching will not risk HIV no longer being suppressed.
TLD and TLE use the same drugs except for one using efavirenz and the other dolutegravir. This difference will not risk a viral rebound when changing between them.
Josh.