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.
Good day
I recently tested positive with cd4 count of 430 and 26000 copies …
I’m on my second month taking my medicine when should I go check if my virul load has gone down ?
And the other thing is how long does the side effects last as I still feel the burn in my tummy and dizziness
Hi Spado,
To know if you’re positive or not, please have a test at a clinic. They will be able to confirm your status.
I tested today my result came back with 1 line and the other was fainted…that means I am HIV postive
Hi Miyanda,
This looks like a false positive from an HIV self test.
Please see this Q&A on what different tests are used to test for HIV.
Was your HIV self test kit a finger prick test? If so this means, if the result is positive, this does not mean that you are HIV positive. It means you need a second confirmatory test. A small percentage of people can test positive with ELISA who are not HIV-positive (called a ‘false-positive’ result).
You have repeatedly tested HIV negative. So it seems that you are HIV negative.
Hello
Am miyanda, i had unprotected sex on 26/02/2019 three days later i started feeling like i had gases in my stomach which lasted for almost a month on April/27/2019 i had a very painful heardche i rushed to a chemist and bought a HIV self test kit i tested myself and i tested positive and was shocked and disappointed. i went to have a HIV test at the clinic it come out negative i also had a quantitative HIV pcr on the same day which came out undetected .i go for HIV test every month it still come out negative, but i have been feeling some body pains in joints and muscle, beneath my feet ,just below my shoulders and blocked nose at times. Since my test at clinic are coming out negative and these pain feelings i have , dose it mean my self test was false or correct? Please help.
Hi Fidel,
It’s great that you want to help your partner, however your partner shouldn’t be taking your ART. PrEP is a very specific ARV, you can’t just take any combination of ART to reduce the risk of transmission, it needs to be Truvada. Also, if your partner is using your meds this will mean that you yourself may not have enough. This could be an issue for you and your health.
If you’re on mediation and your viral load is undetectable there’s no need for your partner to be using any type of ART. This is because when someone has an undetectable viral load they can’t transmit HIV. Please see here: http://i-base.info/u-equals-u/
If your viral load is detectable, then your partner needs to be taking Truvada. Either this or you use condoms.
Hi I’m Fidel I’m positive and dating a negative guy we have unprotected sex at times and he has been taking my ART to prevent transmission I’m just wondering can my own drugs prevent him from getting infected
Hi Thabie,
Did you every have a CD4 count test or viral load test?
Hi I started taking my meds 2013 and stopped 2017 but since 2017 till now I’m testing negative so this thing is confusing me
Hi Lucy,
It sounds like you’re having issues with the efavirenz, this is common. Please see Q3 here: https://i-base.info/qa/what-are-the-most-asked-questions Please talk to your doctor about this. Depending on where it is that you live, they should be able to change your regime.