Q and A

Question

Will someone always test HIV positive – even with an undetectable viral load? – updated answer!

If you have achieved undetectable level and have been so for a period of say 6 months, and then were to have an HIV test at another clinic where they don’t know your positive status, would the test come back as negative because you are undetectable or would it still be reactive?

Answer

For nearly everyone, the HIV tests will still be HIV positive.

This is because HIV tests look for an immune response (called an antibody).

Even if there was an HIV cure – and this might be found one day – your antibody response is always likely to test HIV positive (i.e. be reactive).

Some HIV negative people in early HIV vaccine trials, test HIV positive on an antibody test because of their immune response, even though they do not have HIV infection.

An exceptions if for people who start HIV treatment (ART) within a few weeks or months of their infection. After being on ART for several years, people who used very early treatment, can sometimes test HIV negative with “rapid” HIV tests.

This report includes details of a study reporting very early ART and several years of viral suppression can result in testing HIV negative using rapid HIV tests.

Treating HIV even earlier – within days of infection – means that some HIV positive people never test positive on an HIV antigen test. This is even though viral load (RNA and DNA) has shown they are positive. A study in Bangkok was able to diagnose some gay men in very early infection. Immediate ART meant that many of these people never tested HIV positive – until they had a treatment interruption as part of a cure study.

Cases of sero-reversion (HIV positive people who later test negative) have also been reported for some babies treated immediately after birth.

This answer was updated in August 2018 and December 2017 from a Q&A first posted in June 2001.

97 comments

  1. Roy Trevelion

    Hi Absalom,

    As it says on this Q&A, nearly everyone will always test HIV positive even when undetectable on HIV treatment.

    But you can ask the clinic what tests they did. Please see this link for the different tests used to test for HIV.

    You can ask for this further test to confirm the result.

  2. Absalom

    I tasted hiv positive 2month back from than i stated treatment. And went back to another clinic i taste negative I’m confused help plz

  3. Roy Trevelion

    Hi Adm,

    Unfortunately we are not doctors at i-Base. As we have said, it looks like you are HIV negative. But please talk to your doctor about your symptoms.

  4. Adm

    Good morning Mr /mrs. I need this website to help again, i have sex with hiv positive woman condom broke as i put my panis inside her vagina without ejaculate inside her vagina, i when to hospital within 24hour i start pep without missing a single drug for one month the,after finish pep i have body weakness and several headache till to day 28/04/2020,i test hiv negative 13 time after pep, 4th generation hiv test negative 6 time and 3th generation hiv test negative 7 time, my last 4th generation hiv test negative was in 125days of exposure, my 3th generation hiv test negative last was in 131days of exposure, base of my hiv test results is conclusive i didn’t have hiv or my hiv test results is not conclusive, i still have body weakness since after finish pep till today, i test negative for diabetes liver, std typhoid fever blood pressure, hepatitis b and c all are negative but i test ulcer positive i confused some said ulcers can cause body weakness but i confused i think my body weakness is a hiv symptoms please i need this website to help me out of this anxiety and depression

  5. Lisa Thorley

    Hi Susie,

    Please see Q15 here: http://i-base.info/qa/4141 You’re going to need to ask what HIV test it is that they used.

  6. Susie Q

    In 2009 I tested positive for HIV, my doctor sent me to a specialize clinic to handle the HIV with my pregnancy. I started meds about 2 months after being diagnosis. And about 12 months from the infection date (by my calculation).
    Recently I had to change doctors because I moved and the doctor couldn’t find the original tests, so I was retested. The test came back negative (I assume because of the meds). I have never had a viral load and my doctors states that the type of test that was ran would still pick up on the virus if I was positive. I’m not a doctor but from my research I would test negative on all tests even if I’m positive because of my meds, is this true?

  7. Roy Trevelion

    Hi Christine,

    As Simon says above, there are exceptions for always testing HIV positive. For example, this can be for some people who start HIV treatment (ART) within a few weeks or months of their infection.

    After being on ART for several years, people who used very early treatment, can sometimes test HIV negative with “rapid” HIV tests.

    Is it this rapid text your friend is using? She could ask the clinic if there’s another test they could do to make things clearer.

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