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 Thando,
As long as your partner continues to take her meds, then she’ll be OK. The risk to the baby will also be reduced.
You need to understand that when a women is pregnant and positive it can be a really stressful time for them. Until your partner knows for sure that the baby is OK, she’s likely to be nervous.
Your partners CD4 is great and and her viral load is undetectable, she’s doing really well.
Hi, my partner cd4 count was 910 and VL is LTDL on May, again shes 8 pregnant…shes taking meds well on time everyday…so sometimes she could be so down worried about the baby if is fine, so I want to know is there a chance that her VL could increase while still taking her meds well everyday?
Hi Raymond,
Sorry but we are not doctors at i-Base. But we do give information about HIV treatment to people who are HIV positive. People can have both HIV and Hep B. And we can give treatment info on this too.
Please talk to your doctor about your Hep B results. If you need info about HIV treatment (ART) please let us know.
I tested positive for heb B which was 27000 uit but I took medicine and drop to 500 UI/ml .my last check up has drop to 350 what food should I eat and what does that results mean
Hi Kedibone,
If you’ve been adhering to your ARVs, then it’s very possible that this is a lab error. Are you able to have another viral load test?
I was told my viral load is 124 after I’ve tested undetectable for the past 3 years, what could be the reason for this…….please help
Hi Neecy,
If you’re undetectable on ART you can not transmit HIV even if you don’t use condoms.
Please see Undetectable = Untransmittable (U=U) here.
Hi I’ve tested hiv positive in 2009. Had a bit of ups and downs during that period when I found out but I’ve accepted it and moved on. I’m on ART went for my checkup in April this year and my tests show that it’s lower than the undetectable amount. Can I still infect my partner with this result?
Hi Man,
What did the doctor say? Usually, viral load tests have a cut off of 50 copies/mL. So, if you have a viral load less than that, HIV can’t be detected. Some tests used in clinics have a lower cut off of 20 copies/mL.
But please check with your doctor. A low detectable level can mean that the result is not undetectable. And being undetectable is the aim of HIV treatment.
Have you been on HIV meds long? Or maybe it’s a blip.
Please see this Q&A for more info. However, it’s a good idea to ask your doctor or nurse to explain this result.
I was told my viral load is at LDL…(Low Detectable Level)
I am confused since I don’t know what that means.
Does it mean I am undetectable and cannot pass the virus to anyone?
I am concerned.