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.
Can someone help me understand this because I’m really confused and it’s driving me insane, I will be seeing my GP tomorrow but I I strill can’t understand what is happening.
I had a HIV rapid test done on Friday at a private clinic that came back positive, this test looked for the antigen and antibody, they said it was “only very slightly positive.” and they didn’t have enough blood to retest it so they just diagnosed me with HIV there and then. I was originally being tested for hepatitis B because that is the only virus I have been exposed to by an ex he refused to tell me of his status until his mum told me years after we broke up, this came back negative btw. I never saw these tests with my own eyes so I am just repeating what I have been told. I was told I can buy another kit to repeat the test but i have decided to see my own doctor for further tests.
Yesterday, I bought a rapid at home test from a company called BioSURE that only tests for the HIV antibody and it came back completely negative.
I understand that the window period is 3 months, but if I contracted HIV it was anywhere between 2-5 years ago because I haven’t been with anyone for well over 2 years, I don’t take drugs and I don’t work in a high risk environment. By now I should be testing positive on all tests if I have it because I am well beyond the window period.
Please someone help me understand what is happening!!
Hi Noma,
Please see Q15 here: https://i-base.info/qa/what-are-the-most-asked-questions
Hi I recently found out my boyfriend is HIV positive and we have a baby together but both me and the baby are negative. He said he found out in College that he was positive and started taking treatment (ART) and from there has been testing negative.
Could the negative results be from a undetectable viral load?
Hi Bhaskar,
Please see this link to what different tests are used to test for HIV.
tested non reactive ..took a rapid I guess 3rd gen test because the counsellor told me it’s an antibody only test.. @ AHF clinic .india
exposure was 105 days ago..is it absolutely conclusive ?.
thanks
Hi steel fabrication,
Thanks!
Excellent post! We will be linking to this great article on our
site. Keep up the great writing.
Hi Situs Poker Resmi,
Thank you.
i-Base provides timely and up to date information to people who are HIV positive and to healthcare workers.
Info is evidence based and from clinical trials and observational studies.
I’m now not certain the place you are getting your
info, but great topic. I must spend a while learning
more or working out more. Thank you for excellent
information I used to be searching for this information for my mission.
Hi TK,
HIV treatment (ART) dramatically reduces your viral load. This gives the immune system the chance to recover. Not taking ART means that your immune system is in overdrive and producing more and more CD4 cells to try to cope. Unfortunately, over time if you’re not on ART your CD4 count will drop because your immune system becomes worn out.
Here’s a guide to ART in Pictures. This explains what happens in detail and with pics.