My viral load has increased, should I be worried?
Last November my viral load was 30 and my CD4 was 351. My results today show my viral load is 90 and my CD4 is 479.
Should I be concerned with the rise in viral load?
An increase in viral load after becoming undetectable (under 50) is not uncommon.
This isn’t something you should worry about, but you should take it seriously.
UK guidelines (British HIV Association, BHIVA) recommend repeating a viral load test on the day that you receive a result showing an increase. This is to find out whether the first test produced an accurate result.
There are two reasons why this increase may not be significant.
- Firstly, it is common to have a ‘spike’ or ‘blip’ result. This can be anything from over 50 up to 2000, but ais usually less than 200. Blips can be caused by other infections such as flu or herpes, or a recent vaccination.
- Secondly, viral load tests can be contaminated at the lab giving a false result. One study showed that over 50% of blips between 50 and 500 copies/mL were test errors.
Even when this is likely to be a ‘blip’ it’s still something to take seriously. This is because, even when viral load is relatively low (50-500), HIV can develop resistance. In the long run this could mean that your treatment would stop working. That’s why it’s important to get another test to check this result.
More information about viral load blips and drug resistance is in the guide to Changing treatment and drug resistance.
This answer was updated in January 2016 from a question first posted on 27 May 2012.