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 Melody, before I can answer I need to check whether these are definitely viral load results and not CD4 counts. Also, it would be good to know whether your husband is on treatment and also when you started treatment. Viral load is best to be low, so you don’t want anything to make this higher. CD4 count is the test which is better to be high.
Hi, l have question to ask my viral load result today was 728 and l am wondering how I drink my tablets in time and I exercise a lot and always when we have sex we use protection and my doctor was not happy about this. my husbands viral load was 22000 and they were saying it low. what must I do to make it go up plizz someone help me
My cd4 count is 280 and my viral load is <2500 how can I take down the load to be normal again?
Hi Hlobelihle
Viral load and CD4 results need to be interpreted based on whether or not you are on treatment.
Even way though, a low viral load is good, and anything under 50 copies/mL (sometimes under 200 copies/mL) is called undetectable.
My Viral load was 249 and now dropped to 28 what does this mean
hi Beauty. If your viral load is now detectable, please talk to your doctor about changing to a new treatment. Depending on how high the viral load is, this might explain why your CD4 count has dropped. Please also talk to the doctor about your other symptoms.
I test my viral load for the first time since my CD4 results reduced frm 589 to 260. I also failed virul load. Does this means the treatment is failing? I am now very weak my joins painful.
There’s not a cure for HIV yet. But a lot of work is now going on to find one. In the meantime successful treatment works by keeping the HIV viral load to below 50 copies. Being undetectable like this means your CD4 count can recover, and that can help stop you from getting ill. You don’t say how long you’ve been on treatment. Sometimes the viral load result comes back over 50 and goes back down the next time. It’s called a viral blip, and means you don’t have to change treatment. You can ask your clinic about checking your previous viral load results, and ask for another viral load test.
I’m HIV positive and my viral load is 73 copies. I’m still on the drugs. Can it go undetectable with this? If yes, what’s my chance to be cured?
Hi,
It is great that your viral load is lower than detectable. You can find more information about this here:
http://i-base.info/qa/6477
And more information about HIV type 2 here:
http://i-base.info/qa/36