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 Thembi, what treatment are you on and are you taking it daily? Do you know what your CD4 count is?
A jump this big is most often explained by a lab error. Have you been offered a second test to confirm this result?
My viral load has increase from lower than detected to 33000 copies, I’m very much worried
Hi Malebogo, how long have you been on treatment? and what have your viral load results been before this?
Hi ish am so worried my viral load is very high is 2700 and am talking my medicine in time
Hi Tete, what is your viral load now? and do you have your viral load results for the last few tests you have done?
It is good that you are taking your medication properly. How long have you been taking it? If your viral load is below 200, even if it is detectable, there will be no risk of transmission. U=U applies as long as your viral load is suppressed below 200 while on medication.
U=U: https://i-base.info/u-equals-u/
When above this you should wait for your treatment to work to prevent transmission to your partner/baby.
i want to have a baby but my vl has gone up so I’m worried about transmission to my partner and me getting sick,should I wait until its undetectable,or i will become better as im making sure I’m taking my vitamins and medication properly now?
Hi Lee, yes this is okay. As your viral load is suppressed the risk is minimal to baby. Where are you? In most countries breastfeeding is recommended over formula even when HIV positive as it ensures baby gets their full nutritional need.
I have a vl of 30 and am breastfeeding Is this ok
Hi Busi, what was the result of your last viral load test?
My viral load is increasing I’m worried. Its 1020