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.
I’ve been taking Efavirenz, but I’d been given different regimen too but still experienced the same side effects.
Hi Lucy,
What medication have you been taking since you started meds?
I have been on ARVs for 18 months now but I still experience the side effects even when the regimen is changed. I feel the burning in my stomach and also feel like I’m crazy. I don’t know what else to do cause I’ve also tried medication for heartburn but still the burning is there. I’m even considering to stop taking ARVs
Hi Petra,
It looks like you should not be worried at all.
Your CD4 count is strong. And a viral load result of 22 means HIV is undetectable. Great news. That’s because, if your viral load is undetectable you cannot transmit HIV even if you don’t use condoms.
Please see lots more info about Undetectable = Untransmittable (U=U) here.
Hi all
I’m really worried I have been on arv since September 2018. I did blood tests earlier this year my cd4 count is 780 and viral load 22..I have been religiously taking my meds have not missed a day since I started. My boyfriend that I’ve recently met did something stupid about a 3weeks ago by not wearing protection I’ve always been encouraging him to. I did not disclose my status to him because I was not sure where this was going but i always made sure he wore protection Now he has nights sweats and nausea could I have infected him?
Hi Sakwe,
As Simon says here, for nearly everyone the HIV tests will still be HIV positive.
This is because HIV tests look for an immune response (called an antibody).
But it’s great that your viral load is undetectable.Being undetectable means you cannot tramit HIV even if you don’t use condoms. Please see U=U.
I was tested positive with a cd4 of 567 and after taken ARVs for some months i became undetected. Is it possible that am negative now
Hi Tony,
It’s not common, but it could be an exception.
As Simon says on this Q&A, for nearly everyone, the HIV tests will still be HIV positive. That’s because rapid HIV test looks for an immune response (called an antibody).
An exception is 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.
Do you have access to your viral load and CD4 test results? You can ask the clinic to check them over the last couple of years. And you can also ask to see these test results when you were first diagnosed.
I have been diagnosed as positive and have been on art medications for a couple years now. With that being said I just had a rapid hiv test at another clinic and the results came back negative twice. Is this common?
Hi Precious,
An ELISA test is very accurate. Its rare that they are wrong. However, if you think that this may be the case you’ll need to have another test done. If its possible you should ask to have a viral load test done.