Question
What does a low but detectable viral load mean?
22 August 2012. Related: All topics, CD4 and viral load, Resistance.
Way back in April 2011, I started HIV treatment.
At that time my CD4 count was 250 and my viral load was 29, 000. My ID doctor prescribed Combivir (AZT/3TC) and Sustiva (efavirenz).
In December my lab results were CD4 423 and my VL was undetectable.
Further results were carried out in March and in July 2012 however these results got me worried.
My lab results for March indicated that my CD4 dropped from 423 to 380 and my viral load has increased from less than 20 to 87.
On enquiring with my ID doctor he informed me that such a increase in the viral load could probably be a blip and he wanted to see the trend of another 2 lab results.
Today I have called for my results and found out that the viral load for the test carried out in July 2012 increased once again from 87 to 123 – CD4 count not yet established.
Even though they’re saying that such an increase is of insignificant value, I am still being very concerned about these results. Could it be that the treatment is failing?
Looking forward for your answers, please.
Answer
Hello,
Thank-you for your email.
The British HIV Association treatment guidelines define virological failure (treatment failure) as two consecutive viral load results of more than 400 after a previously undetectable viral load. This is the point at which treatment change is indicated.
Low levels of detectable virus (where the viral load is more than 50 and less than 400) occurs in up to 8% of people on treatment. Often this can be reversed through improved adherence or alteration of doses. Generally this is not considered treatment failure and not a reason to recommend changing treatment.
If your viral load is rebounding due to resistance you would expect to see a significant rise in your next viral load test. If your viral load remains at this low but detectable level your doctor may want to measure drug absorption levels, or talk about adherence.
Hi Titi,
What does the doctor say about your results?
HIV treatment (ART) aims to reduce viral load to undetectable. And it’s important to be on ART if you’re pregnant. That’s because having an undetectable viral load by the time your baby is due can reduce the chance of HIV transmission to close to zero.
A viral load that’s lower than detectable means that the HIV meds are working. But we can still test HIV positive even with undetectable viral load.
Please talk to your doctor about your ART and your results. You can also discuss what HIV treatment your baby needs after birth.
Here’s the guide to HIV pregnancy and women’s health.
I’m pregnant and got diagnosed when I tested for pregnancy that was 3 months back..I was 20 weeks pregnant at the time.
I was on and off treatment during that 3 months
Now I just got my viral load results and I’m lower than detectable limit with an input limit volume of 0.200
Could this have been a false positive??
Hi Lee,
First, congratulations on the news that you’re going to have a baby.
Can you confirm with your doctor that you tested HIV positive? Please let us have more information about your HIV tests.
Hi m Lee n m pregnant I tested for HIV my results were negative I did more blood tests now I received my results as follows: HIV viral load, lower than detectable and input volume is 0.200 mL . What does this mean
Hi TT,
If your viral load is lower than detectable then it sounds like your HIV drugs are working well.
The good news is that HIV meds do not stop you from having children. For example, women around the world have taken HIV drugs safely in pregnancy now for over 20 years. This usually involves taking at least three drugs and is called ART.
Have you been taking ART for long? And please also let us know what HIV meds you’re taking.
Hi
Am TT my viral load is lower than predictable, one day they advice me that the drug that am using, I cannot be able to have family any more because they are too strong, is it possible to change them.
Hi Zeee,
You’re doing great. Your CD4 count is high and your viral load is undetectable. Your HIV is under control.
Yes you can try for a family, your partner won’t be at risk. Please see here: http://i-base.info/u-equals-u/
Early this year February I discovered that am HIV positive I started treatment right away with VL OF 1000, NOW IT’S BEEN 8 MONTHS ON TREATMENT with Cd4 count cell of 644 with VL of <40 copies. Can I start planing to have a child now? My partner is HIV negative
Hi Shan,
Your HIV is under control, this is excellent news. Because your viral load is undetectable, so less than 50 you can’t transmit HIV to your partner. Please see here: http://i-base.info/u-equals-u/
My cd4 is623 and viral load is 20.is there any kind of risk for my partner if I not take condom? If I want baby now what should I do?