Question
My viral load has increased, should I be worried?
1 January 2020. Related: All topics, CD4 and viral load, Changing treatment, Resistance.
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?
Answer
An increase in viral load after becoming undetectable (under 50) is not uncommon. But if you have been taking your meds and this is still less than 100, then this is either a blip or a lab error. Please don’t worry.
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.
- It could just be a ‘blip’. This can be anything from over 50 to 200, but can sometimes be higher. Other infections such as flu. herpes or COVID, or a recent vaccination can cause a blip.
- It could also be a lab error. 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 important to check. This is because resistance can still develop if viral load stays detectable for a long time. This is even when viral load is relatively low (50-500). This could stop ART 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 2020 from a question first posted on 27 May 2012.
Hi Zimasa.
Rhanks. Great that you HIV meds are working really well.
Your other health issues are also important. Changes in diet and exercises can help for both of these. Plerase talk to your doctor about how being more active physically and ho a more healthy diet can help both diabetes and blood pressure.
These are both important and it is good to take them seriously/
My CD4 is 400 plus and my viral load is undetectable, I am pre-diabetic and also am on meds for BP. should I be in danger and must I be worried about al these health problems.
Hi Jimmy, thanks, it is difficult to comment without more details, including where you live.
In the UK the viral load would be check when the higher result came back. If it is still this high, your doctor will want to find out what could have caused this, including adherence advice and testing for drug resistance.
Sometimes viral load will go back down and sometimes it might b=mean changing to a new combination.
This guide has more info:
https://i-base.info/guides/changing
my vital load was 58 now its 543 should i worry
Hi Nompumelelo, thanks, VL of 200 is still so low that it could just be a blip. In the UK this would just be checked again in four weeks and in most cases it becomes undetectable again. Be especially careful with adherence until you find out. Testing again in four weeks is important in case of the small chance that it might go higher. If you have already been taking all your meds at roughly the right time, it is even more likely to just be a blip.
Even though viral load guidelines might be different in other countries please ask your doctor to do this – or to explain why not and when it will be done.
This is not a big enough change to have any impact on your weight.
hi i want to find out my viral load was suppressed but last i went formy blood result and is 200 i dont know if i should worry, i feel like am losing weight also please help
Hi Con, no your partner is not in danger. As your viral load has been consistently below 200 and you are on treatment, it is impossible for you to pass on HIV via sex.
This is called U=U: https://i-base.info/u-equals-u/
It means that when HIV treatment suppresses viral load so much, you cannot pass on HIV. It is safe to have sex without a condom.
Hi my viral load in 2020 it was 59
2021 less than 40
2022 48
2023 May less than 20
2023 November less than 20
So my partner is negative and not taking prep
Is he on danger or not please assist