Question
Should I be aiming for a viral load of 0?
5 May 2011. Related: All topics, CD4 and viral load.
My doctor tells me the aim of HIV treatment is to be undetectable which I understand is a viral load of less than 50. Can you then ever get to a case where your viral load is 0? If so, should that ultimately be the aim of your treatment?
Answer
Thank you for your question.
HIV lives inside one of your immune cells, the CD4 T cells. These cells can sleep in reservoirs around the body. HIV treatment only works on active cells and so cannot reach those cells that are ‘resting’ in the reservoir. These cells wake up sporadically and are the reason you always have some virus.
Your viral load is never zero. At very low levels measuring viral load is dependent on the sensitivity of the test itself. Most tests have a cut-off of 50 copies/mL.
In research studies using more sensitive tests, about 50% of peope undetectable to less than 50 are also undetectable on a test sensitive down to less than 5 copies/mL. Many of these people are undetectable on a test sensitive to 1 copy/mL but they with still have virus somewhere,
The genital tract, the brain and CSF, the lymph nodes are other areas where HIV levels can be higher, but these are difficult areas to test.
Viral load below 50 the viral load is probably bliping up and down below 50 or even below 5 rather than being stabilised at a fixed level.
Viral load above 50 appears to be the cut-off value, above which there is a possibility resistance can occur. This is why the aim of less than 50 is set.
Hi Queentt, do you mind explaining what you mean by your ‘faith’? A viral load under 40 is excellent and means that you are undetectable (below 200). While your viral load is this low you cannot pass on HIV via sex and is explained by the U=U campaign: https://i-base.info/guides/testing/uu-undetectable-untransmittable
My vital load is under 40 copies as of last six months what’s my faith
Hi Screenivasulu, a viral load is very good. It means that your viral load is being suppressed by your medication. Do you know the exact value of your viral load?
I have viral load below 1000 means what?
Hi Noko,
This can mean that your viral load is just 2 copies/mL. It could be that this is a log value. Log values are sometimes used for viral load so that differences in large numbers can be shown on charts. Here’s a link to the Log conversion table.
But this result looks like it’s from a very sensitve test which is not always used for viral load results.
My viral load is 0.200. What does it mean?
Hi Nhuza,
Because your viral load is undetectable its not possible for you to transmit HIV to your boyfriend. For more info please see here:
http://i-base.info/htb/32308
With regards to telling him, I really can’t tell you what to do. However, have you thought about asking him what his thoughts are about HIV? Being able to tell him that he isn’t at risk might help.
Yes you can have children, as Q6 here explains:
https://i-base.info/qa/what-are-the-most-asked-questions
I am HIV and on tribuss meds, my specialist confirmed that my viral load is working good, undetectable and my CD4 count is increasingly rapidly. Will I use tribuss meds for the rest of my life, I’ve been living my life without sex since I’ve started medication in April 2016, but now am having a boyfriend and is longing for a child and I’m scared of telling him bcoz he can run away and leave me for now we are using condom , will it be possible that I cannot have complications on pregnancy and I will not infect him with virus. I love the guy
Hi Lynne,
What a viral load is, is discussed here:
http://i-base.info/ttfa/section-2/8-what-is-a-viral-load-test/
Is it possible to have a viral load without HIV infection?
I’m a 1st year med student specializing in HIV, I’m not HIV poz but I’m suffering from flu and cold at the moment, so want to test my blood at the lab next week for viral load. I would think it will be zero.