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.
Hello am confused , I have a friend who was born and living with HIV but she takes her medication daily, whenever she goes for an HIV in another clinic she tests negative.
Hi Nelly,
Thanks for asking a question about your sister’s health. But, ARVs don’t affect a woman’s menstrual cycle. Therefore this is something that she may wish to discuss with a doctor or nurse.
Hello, am Nelly, I have a sibling on treatment, her treatment was changed and she has not had periods for three months now. do ARVs affect the reproductive system of females?
Hi Anonymous,
I’m sorry, your story does sound confusing.
What does the doctor say about your results? Do you have access to your viral load results? A few people have an immune response that can control HIV and keep the viral load at undetectable. It’s great that you’ve been healthy to this day. But it’s a good idea to discuss this with the doctor or clinic. That’s because they recommend that all HIV positive people should think about starting HIV treatment (ART) even if they manage to control HIV without it. Please see this link to people who are slow progressors. You can also ask the clinic to explain what the nurse meant about foreign HIV.
Please see this Introduction to ART, and ART in Pictures for more info.
Hi
I’m really confused, I’ve been confused for years now.I’m 23 years old I first went to get tested at the age of 16years,it came back positive and I was still a virgin.I told my partner at the time and he didn’t believe me,so we had unprotected sex, so after few weeks we went to get tested his came back negative and mine positive again.even today he still negative. I’ve went to every different clinics and always comes back positive, this year I went to get tested and came back positive and that’s when I told the nurse that I’m confused on how I was infected cause I’ve never had any simptoms or got sick to the point of being hospitalized all my life I’ve been healthy till this day and I’ve had unprotected sex few times and my previous partners they are all negative, so the nurse told me that my HIV is a foreign HIV, and she said my immune system is fighting the disease that’s why I’ve lived and stayed this strong for so long..then she advised me to take treatment.. I’ve been avoiding treatment all my life cause I don’t feel like I have HIV or maybe I’m in denial and I’m scared to take treatment to later find out I was never positive or scared to not take treatment to later be infected to the point where its too late to take treatment.I’ve also been considering going to private hospital to get my blood tested and find out what could be wrong with me cause I feel like public clinics and hospitals are failing me..I don’t know what to do
Please advice..
Hi Lerato,
Did you start meds quit quickly after being infected? If you did, please see the above post. If you didn’t then you need to discuss this with your doctor.
Tested positive and was immediately put on ARV. Went for another testing it came back negative how possible is that? Two different tests came back negative. It was done on a rapid test, is it because I achieved an undetectable viral load?
Hi Anonymous,
I’m going to be direct. It’s none of your husbands business if you take ARVs or not. This is about you and your health. Given that your CD4 is less than 200, it’s important that you start treatment, and by this I mean ARVs. ARVs are what controls HIV, not traditional medicines. If you don’t use ARVs your CD4 count will continue to drop. Hence why it’s important to be on medication: http://i-base.info/guides/side
If your husband isn’t happy about you wanting to ensure that your health improves, then this is something that you may wish to reflect upon.
Hi! I was diagnosed HIV positive and my husband tested negative now doesn’t want me to take arvs he want met to take traditional medicines my CD
4 count is very low less than 200 , does he want me to die? pls help
Hi Masego,
The frequency of viral load testing varies depending on where someone lives. If you were in the UK your viral load would be tested on a monthly basis until it became undetectable. In other countries it can be every six months. Ideally you should have it checked now, however as to whether this is possible will depend on where you live.
If you’re still feeling dizzy,this is something that you need to talk to your doctor about. They may suggest that you change to another type of ARV or ask you if you’re taking your medication as prescribed.