Q and A

Question

What do my viral load test results mean?

Please can you explain how viral load results mean?

I got my results back and I don’t understand them. It says log units is 2.777 and my RNA copies is 599 cp/mL.

Is this low or high? My CD4 count is 697.

Answer

Hi

Thanks for your question – and it is good that you want to understand your test results.

Sometimes this can be dfficult if your doctor has not explained them clearly. It is also okay to ask your doctor or nurse to explain anything that you are not sure of.

Viral loads tests tells you how much virus is in a millilitre of blood (or another body fluid being measured).

When not on treatment, viral load can range from undetectable to several millions. For anyone on HIV treatment (ART), viral load should ideally get to undetectable, This is defined as being less than 50 copies/mL.

Your test results are the 599 copies/mL, so your viral load is still detectable at 599.

The ‘2.777 log units’ from your test results is a slightly complicated way of saying exactly the same thing as ‘599 copies/mL’.

Because viral loads have such a huge range of numbers they are sometimes expressed in ‘log units’ to make it easier to write them on graphs and diagrams. Doctors and scientists use log scales to look at changes to viral loads over time. See this table of log units compared to viral loads in copies/mL.

Whether this is considered high or low depends on whether or not you are on treatment.

  • If you’re not on treatment yet this is a relatively low viral load, which is a good thing.
  • If you are on treatment, then if you only recently started ART, your viral load might still be going down.
  • If you have been on treatment for more than six month, please talk to your doctor about why the results in not undetectable.

For more information about viral loads and how they relate to both treatment and infectiousness you can also have a look at the following links:

Viral Load and Treatment
Viral Load and Infectiousness

If you tell me if you are currently on treatment or not I can provide more individual information, Also, if you are on treatment, when did you start?

This answer was updated in January 2016 from a question first posted on 5 April 2012.

202 comments

  1. Simon Collins

    Hi Fernando, thanks, you are doing really well on treatment and you have nothing to worry about. Viral load sometimes blips and becomes detectable at low levels without it meaning anything. Anything less than 200 is still called undetectable. Sometimes it is just because the test is less sensitive at very low levels. It is okay to just check in July.

  2. Fernando

    Dear Sir/Madam

    I ve started taking Dovato, on 16 september 2021 , 1500 copies ( newly diagnosed).
    On 22 november 2021, i was with less than 20 copies , 840 CD4. After two years,same less than 20 copies. My CD4 were steadinly increasing every six months.
    In march 2024, i had 1441 CD4, but 23 copies. Shall I worry? I have new tests
    On 15 july.
    Thank you

  3. Josh Peasegood

    Hi Fernando, a viral load of 23 and Log 10 1.36 mean the same thing. It is different ways of expressing the same result.

    The conversions between log values and copies/ml are listed here: https://i-base.info/ttfa/learning-resources/units-of-measurement/

  4. Fernando

    Dear sir/ madam
    Last test
    23 viral load
    Log10. 1,36
    Whst that means?
    Thank you

  5. Josh Peasegood

    Hi Botle, congratulations on having a baby. Yes you can breastfeed. It is great that your viral load is LDL. The risk of transmission to baby is as low as possible.

    To safely feed baby with breastmilk it is recommended to only use breastmilk until baby is 6 months old. Switching between different types of feeds can irritate baby’s tummy. Even with a viral load LDL, the irritation caused by changing feeds can increase the risk of transmission.

    After 6 months baby will have a developed tummy and will be able to change between different feed types without a problem.

  6. Botle

    Hello there
    Can I still breastfeed my 3 month old baby my viral load is LDL

  7. Josh Peasegood

    Hi Mickey, this is because there are some parts of our body called viral reservoirs. These are sites where the virus is not actively replicating but it is still present.

    Because the virus is not actively replicating, it is not possible for treatment to get rid of this HIV from the body. Treatment works by preventing replication. When it is not replicating, there is nothing for the treatment to work on.

  8. Mickey

    Hi. Why ARV can’t suppress virus to 0? Even We have undetectible viral load, some cells od virus are in our body. Why ARV can’t destroy all cells of HIV in our body?

  9. Josh Peasegood

    Hi Barry, why have you not had ARVs for the last 9 months? and do you also know your CD4 count? A viral load in the thousands means that HIV is going to be having some impact on your health. ARVs will be able to suppress this and prevent damage to your immune system. ARVs will also help your immune system recover.

  10. Barry

    My viral load is 4161 cp/ml is this bad news?
    I haven’t had ARVs for over 9 months now.

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