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 Popi,
The good news is that, as your viral load is undetectable, you cannot transmit HIV to your partner even if you don’t use condoms.
It looks like your ART is working very well. Your viral load is less than 50 copies m/L, and your CD4 count is strong.
Please see Undetectable = Untransmittable (U=U) for more information.
Halo. My latest test result on viral load is detectable with <40 copies after taking my ART since june 2018 to july 2019. My CD4 improved quite a lot, and on my latest test it showed that CD4 is 950. With that kind of results, will I still transmit HIV to my partner? Thanks in advance.
Hi Tembie,
When someone has an undetectable viral load they can’t transmit HIV to their partners. Please see here: http://i-base.info/u-equals-u/
Good day
My CD4 count is 683 and my viral load is lower than undectedable limit is possible to my partner to get positive if we are not using condom
My CD 4 is 605 and viral load is Lower than Dectable Level. Am I a person who can transmit the decease to others.
Hi Amit
Your HIV is under control, so no you cannot transmit HIV to sexual partners.
Hi PP,
When someone has a lower than detectable viral load this means that their HIV is under control. It also means that you cannot transmit HIV when having sex without a condom.
Hi my hiv is lower than detectable limit what that means
Hi Alice,
You have a strong CD4 count. But your viral load is still detectable at 400 copies/mL. So there can be a risk to your partner if you have condomless sex.
What HIV meds are you taking? And how long have you been taking them? Please let us know.
Hey my CD4 count is at 1079cells/ml and viral load is at <400 copies/no what does that mean and can I infect my partner if we have unprotected sex