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, am Precious. I tested HIV negative on 2 occasions at different hospital but the Elisa test came back positive from another hospital ,what does that mean? Does it mean am positive.
Hi Glenda,
It’s great that your viral load is undetectable. Here’s the latest info on Undetectable = Untransmittable (U=U).
But as Simon says above, for nearly everyone, the HIV tests will still be HIV positive.
This is because HIV tests look for an immune response (called an antibody).
Hi they say I’m undetectable.will my results say positive or negative?
Hi Fred,
As Simon says above, for nearly everyone, the HIV tests will still be HIV positive. This is because HIV tests look for an immune response (an antibody).
However, if someone is born positive and started HIV treatment (ART) straight away, perhaps they could. This is probably not because HIV has been cleared.
But please see this link (also above) http://i-base.info/htb/32657. This is from a study that looked at people who started ART very early after becoming HIV positive.
This says, the negative results from the waning HIV antibody responses are rarely reported when ART is started later in infection. Importantly, the results only highlight a limitation for the test sensitivity and not that HIV has been cleared.
Can someone born HIV positive & has been on treatment for 19 years test negative on a rapid antibody test
Hi Boity,
When someone starts medication, their viral load should become undetectable within 1-3 months. Therefore, as long as everything is OK, your viral load should be undetectable by June. Once a persons viral load is undetectable they cannot transmit HIV. Please see here: http://i-base.info/u-equals-u/
If you stop taking medication, your viral load will rebound.
Hi, i tested positive on the 3rd of Jan 2019 and started treatment immediately (my CD4 count was 734 and viral load 10800).I will be taking my blood tests again in June to monitor the viral load. Let’s say for e.g the virus is found to be undetectable in June, can i have unprotected sex without infecting my partner as i want to have a baby? And another question is what will happen if i stop medication after achieving an undetectable results (and practicing safe sex all the time)?
Hi Javonti,
I’m sorry to hear about your recent diagnosis. Testing HIV positive can come as a shock to all of us. However, this link is about if you’ve just found out you’re positive. It begins by saying, you can try to slow down, to take time, it’s going to be okay.
Did the clinic do another HIV test to confirm your result? You can ask them to do this if they didn’t.
As you are on treatment please see this Introduction to ART.
Please let us know how it goes. If you have any questions about treatment and your meds you can ask a question here.
Hi I did a test yesterday to my surprise it came back positive I am still in shock and disbelief I am on treatment is there a possibility that the test might have been a false positive
Hi V,
If you’ve not had any risks, then its not possible to be positive. Its sounds like there were issues with the first test. Having a confirmation test will help.