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 Comfort,
Are you taking HIV meds? The clinic should be monitoring your VL and taking your CD4 count. Montoring these results can make sure you’re taking the right treatment.
For info, here’s a guide to HIV in Pictures that explains treatment.
I have not gone for VL before and not done cd4 for a year now? What is the risk?
Hi Olu,
It is possible that your viral load could have become detectable again due to you missing meds for 3 days. Therefore, if you’re now back on them, if its possible you should have another test done.
I been on ART for 4 years within the last two years I missed a couple of tests. Within the last and the one before there was a difference of between 30 to 5600…
I however remember that I missed taking my drugs for like 3 days prior to the test. Is it possible before the VL raise?
Hi Sammy,
Your viral load is undetectable which is excellent, this means that your HIV is under control. Your CD4 count has risen really well and is high. HIV wise you’re in an excellent position.
hi…i took the transfer from one clinic to another so I want to know what does the doctor mean on my transfer letter…she wrote cd4:743 and vl: LTDL …DOES THIS BAD FOR ME OR WHAT…I STARTED TREATMENT LAST YEAR 2017 ON MARCH WITH CD4: 450
Good day Lerato,
Lower than detectable means undetectable. So this can be described as a good thing! Being undetectable means that HIV cannot be transmitted if you have sex without using condoms. Here are questions and answers for U=U (Undetectable = Untransmittable).
Good day what is meant by lower than detectable ? Is it good or bad thing?
Hi Lelo,
Anything under 50 is classified as being undetectable. Lower than the detectable limit means that its less than 50.
please explain to me what does “lower than detectable limit” means because my last Viral laod was 20copies does this means it has increase?