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 Ntombenhle, if your viral load is undetectable, you dont need to worry about using a condom with partners, so long as you are both happy with this.
What happen if im taking my arvs and my partner did not take it but when we having sex we do not use condoms where as my viral load is lower than the detactable this means i am going to transfer the disease or im going to raise my viral load in my body?
Hi Enhle, this might be a side effect or a symptom of other health problems. Please talk to your doctor about this. It is fine to change the time by an hour or two if you want to try this. But please still tell your doctor.
Does the arvs cause a heartburn always after taking it?changing times like when i used to take my arv at about8 in the night then what would happen if the following day i took it by 8h30.?
Hi Khosi,
When someone has a lower than detectable viral load this means that there viral load is less than 50 copies. In effect it means that you’re meds are working and working really well and that you can’t transmit HIV through sexual intercourse.
hi i started arts on November n my Cd4 was 404,after 3 mnths my viral load came up lower than dectatable, n in November my viral load came back lower than dectatable and my Cd4 was 589,what i don’t understand is the term lower than dectatable could u pls xplain it to me.
Hi Basty,
Unless a persons viral load is less than 50copies, then yes there is a possibility that there could be transmission. Therefore, its important that the women in question has the opportunity to test.
I’m hiv positive I sleep with a girl without a condom and I didn’t pull back when the sperm came out my VL is < 150 is it possible that she is infected?
Hi Arun,
Please see here:
http://i-base.info/qa/6570
What does it mean when the viral load is 2451?