Question
Will someone always test HIV positive – even with an undetectable viral load? – updated answer!
5 September 2018. Related: All topics, CD4 and viral load.
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.
Hi Sakthi,
I can’t really comment on your sisters weight. If this is an issue she’ll need to discuss this with a doctor.
Its common to have side effects in the first few weeks of starting meds. These usually go after 2-3 weeks. If they don’t then this is something to discuss with the a doctor.
There’s no reason at all why your sister shouldn’t be with her child. She isn’t a risk to her.
Hi. my sister and her husband having HIV and diagnosed recently…Her 2 year baby was diagnosed negative. Her CD4 count is 654. But her weight is below 45. she have started her ART from last two weeks…. but after taking ART, she feel unhealthy and tiredness… Is there any problem with ART or her low weight.. and also is there any problem to child if the baby with her….
Hi Glowing,
Being diagnosed with HIV can be a shock. Slow down, give yourself some time to breath. You’re going to be OK.
HIV is no longer the illness it used to be. Its now a very manageable health condition and one that is easy to treat. The medication that we have is so good that our life expectancy is just the same as it would have been had we not contracted HIV. Its also still very possible for people with HIV to have families.
You being on medication is the right thing to do. This will allow you to control your HIV. There’s more about starting medication here:
http://i-base.info/guides/starting
With regards to your partner, when a couple are diagnosed around the same time, its common to feel distant and to question the relationship. Sex is also quit often the last thing that people want to think about. This is common and is part of the process. The process of healing that is. As to what happens now only you can deiced. Being able to talk may help.
I was tested positive on the 18th of May 2018. I went with my fiance who has been seriously ill for a while, he was tested positive which I was ask to do same an
d it came out not good. The doctor said am of the first stage and placed me on anti retroviral drugs. My question is, can I b save? Because I hope and pray for God healing taking the drugs. Advice please because I have plans for myself and I do not want to have sex with him any more.
Hi Diana, i-Base doesn’t answer questions about testing. All frequently asked testing questions are already answered here.
I met this guy recently and we had talk about getting tested together and suddenly he started demanding that I go tested and show him my results which I haven’t done thus far and he promised to send me his and which we he hasn’t done thus far. Then boo we had a sexual encounter whereby none of us initiated the the use if a condom and now he wants the HIV tests from me and I suspect that his not keen on us getting tested together. Is the anything I should worry about or is he hiding something. I’m a bit concern about his view on getting tested as I keep telling him you test first then you have a sexual encounter not the other way round.
Hi Louies, It’s great that you’re undetectable. It sounds like your treatment is working well. But being undetectable means that your treatment is holding your viral load to under 50 copies. There’s more about being undetectable here.
Hello guys , I was diagnosed hiv last 2015 , I started to get my treatment since then and last year my doctor said I’m undetectable! Is it possible that, if I have another test for hiv I will become negative ? Cuz im planning to move in Canada ! I appreciate your answer guys ! Thank you
Hi, the answer above was only about HIV and only in the case of most people. It can also show limitations of some types of HIV tests. For example, some “rapid” test might show negative in people who start very early treatment and keep viral load undetectable for many years.
http://i-base.info/htb/32657
[Quote]Answer: Simon Collins
You will still be HIV-positive.[/quote]
Not exactly.
If a person has had the measles (a virus), both of the same antibody test would show that the person has the antibodies for measles.
The same is true of any virus. Chicken pox is a virus. Even if a person had chicken pox 30 years prior, the antibody test would show the antibodies in the blood. In fact, it’s good to have those antibodies.
A flu shot is designed to invoke an immune response that produces antibodies to the strains of flu proteins in the vaccine. The same antibody test would show antibodies to the flu. But, that person does not have the flu nor are they “Flu Positive”.
So, really, if there is no virus in the blood, a test that shows the antibodies for any virus does not, in fact, mean you have that disease.
There are a few known persons in the world who are super resistors to certain viruses (HIV included). They can encounter the virus and never get sick. Yet the antibody test would show they they had the antibodies for HIV.
So, it’s not as simple as if you have an antibody you are positive. As long as you maintain an undetectable viral level, you do not have active HIV disease.