Question

Is my viral load of 30 copies/mL undetectable?

6 August 2024. Related: All topics, CD4 and viral load.

Hi, I have a few questions. My viral load starting off in May of this year was 227,000. Now, as of Aug 1st, it’s down to 30 copies/mL.

Does this mean I’m undetectable?

I’m in the U.S. (Not sure if there are different tests that measure differently). The test I received is called HIV1 RNA by PCR and it was done through lab corp. On the result it says “ the reportable range for this assay is from 20 to 10,000,000”

Also the other result for the test said “ log10 HIV-1 RNA ……1.477 (log10 copy/ML)”

Answer

Answer: Simon Collins

Hi there

Thanks for your email and these are all great questions.

First, great that you are now on treatment and it is still working so well – these are great results.

HIV guidelines usually use a cut-off for being undetectable of getting below 50 copies/mL. Even though some tests are a bit more sensitive and can measure down to 40 or 20 copies/mL, the differences once you are below 50 don’t make much difference.

The test in the US still measure the same way, but different labs and hospitals in every country, including the UK, can sometimes differ. Some labsa and hospital here use the 20 copy cut of and other use 50 copies/mL.

The range tells you the sensitivity of the test – which iin your case has a 20 copies/mL lower cut off. At the other limit, it can measure up to 10 million copies/mL which is often how high viral load can go in very early infection,

Finally, some labs report the results as log copies/mL. A log is usually a factor of 10. So 1 log is 10, 2 logs is 100, 3 logs is 1000, 4 logs is 10,000 etc. Log scales are used to fit vary large and very small numbers on the same scale to be more manageable.

So getting your viral load from 227,000 to below 20 is about a 4 log drop – and this often takes a couple of months,

This link has a conversion table:
https://i-base.info/qa/factsheets/viral-load-converting-log-values-to-numbers