Question
What does a non-detectable viral load mean?
26 May 2021. Related: Adherence, All topics, CD4 and viral load, Living with HIV long-term.
I am now into my 22nd year of living with HIV and have been non-detectable for 10 years now. I have been on antiretrovirals the entire time, have tolerated them fairly well and have never been seriously ill. I started with a CD4 of 80 and have been above 350 for many years going as high as 670 in 2007. In 2008, my CD4 is 505. My viral load remains non-detectable. I know enough to be very grateful.
Also, as a sidebar note. I experienced facial wasting ten years ago and had facial filler (Sculptra) injections last year. I must say that the results, even after two sessions, were amazing. I had three treatments total and I remain extremely pleased with the outcome. I have my face back! I have medium brown skin and suffered no scaring at the injection sites. This process has really given my self-esteem and quality of life a super boost.
Answer
Thank you for your question.
Viral load test is a key marker to whether treatment is working. When you achieve a non-detectable or undetectable viral load it shows that the treatment is working.
An undetectable viral load means that the level of HIV in your blood is below the threshhold needed for detection by this test.
Being able to maintain an undetectable viral load for ten years is great. It shows your good adherence and that your treatment is working. So, well done and keep taking your treatment.
This link has more information about different cut off levels for an undetectable viral load – ie 200, 50 and 20 copies/mL.
https://i-base.info/qa/10953
This answer was updated in May 2021 from an original question in February 2008.
Hi Lisa,
When you are not on treatment your viral load will be higher than your CD4 count. This is very normal. In the UK the recommendation is to start treatment if your CD4 is under 350, or your viral load is over 100,000. There’s more information about CD4 counts and viral loads in our starting treatment guide.
The only way to reduce your viral load is to take ARVs.
Can you tell me roughly what your numbers are?
I am having a problem I’ve been hiv+ since 2010 November and still not on treatment bt my viral load is higher than my cd4.I don’t know how to keep it low
If your viral load is undetectable your risk of transmitting HIV from heterosexual sex is very low. We are not sure how low this is, but it is cautious to think that this is never zero.
Even if you are not putting your partner at risk, at some point it seems important that you talk about HIV. This is in terms of developing a relationship.
The test results from the last time you had unprotected sex will not be accurate as it was only two days after. That single risk would still be very unlikely for him to become positive.
Hey. I have been using treatment for HIV and its said that my viral load is undectable for the past year. I have a bf and i fear telling him my status. We had unprotected sex 3 months back and he got tested after 2 days of us having sex and tested negative. i fear that he will test and it will appear positive and may hate me. Im scared cos he is not circumsised.
Hello,
If you have HIV even if your viral load is undetectable an HIV test will still show HIV positive. This is because HIV tests look for antibodies, the body’s response to HIV, rather than for the virus. These antibodies will remain in your body for life, meaning you will always test positive.
If I get tested will it show positive if my viral load is non- dectectable?
If your viral load is undetectable and has been for over 6 months then the likelihood that your partner will be infected is very small. To give you an idea of how small please follow this link to the Swiss statement. If you are feeling unfulfilled and are having thoughts about taking another sexual partner to fulfil your needs then maybe you should try and talk to your partner to tell him how you are feeling. Coming to terms with HIV infection within a relationship can be hard on both partners. Alternatively, have you thought of trying female condoms? Some men prefer them as they are not as restrictive as male condoms, you can feel more through them as they are made from different material and the inner ring can rub on the end of the man’s penis making it more enjoyable for him.
I have been living with HIV for five years, started HAART Dec 2009 when my CD4 count was 284. I have just received my first viral load test result which is undetectable with a CD4 count of 607. I live with my HIV negative partner who is also the father of my baby. We have been together for 3 years and have always had unprotected sex until I started taking my HIV medication and I had to disclose my status. Subsequently our sex life has been next to non-existant. He does not like condoms but is terrified of having unprotected sex with me. I feel rejected as a result and find myself fantasising about having another sexual partner, protected sex of course. I believe if my partner and I could continue having unprotected sex he wouldn’t get infected as has been the case for the past three years. He is circumsised. I’m however too afraid to even suggest it and maybe it is selfish of me to think he could risk infection. I’m so unfulfilled.
Hello,
If your viral load has been undetectable for more than 6 months and neither of you have any other STIs then the risk of transmission is low. However, to avoid infection with other STIs it is important to always use protection. Thanks
Hello, I have maintained my viral load at below detection level for about 9 months now. I have recently had bareback sex with someone. I would like to know how high is the risk that this guy could get the virus from me?