Question
Why did my viral load stay undetectable after I stopped ART?
5 March 2026. Related: All topics, CD4 and viral load, Cure, Stopping treatment.
I am treated in the UK and I stopped HIV medication just over two years ago as was undetectable in that time. When I was diagnosed 20 years ago my CD4 count was 18. My viral load was 100,000+. Only recently has my viral load become detectable (around 24,000). Why was I undetectable for so long?
Answer
Hi there
Thanks – this is a great question to show the range of different ways that HIV can work.
HIV can sometimes progress very quickly in some people and very slowly in others. This is something that we have always known.
More recently though another response to HIV has been reported, related to HIV treatment.
This is similar to your case when HIV treatment is definitely needed because of a high viral load, but then stays undetectable for some reason, if treatment is ever stopped.
This is a relatively rare experience though because most people see their viral load rebound very quickly if they ever stop treatment.
Your experience of undetectable viral load for a time after stopping ART was first described in a small group of French people called the Visconti cohort.
People with this response are also now called post-treatment conroller’s (PTCs).
Although in some people this post treatment control can last several years, unfortunately viral load does generally rebound later.
Researchers are still trying to explain why this happens with some people and not others, including whether studying these response might help to find a general cure.
So far, researchers can’t explain this, nor what would happen if people repeat the break in treatment and whether it would happen again.
As your viral load is now detectable, your doctor should talk about restarting ART again. Maybe also about sending your notes to researchers that are studying these immune responses, if this is something you want to help with.
Best wishes
Comment