Question
Why is my viral load not undetectable?
5 November 2012. Related: All topics, CD4 and viral load.
Good morning,
I’m confused about my lab results i.e. CD4 and VL numbers!
I just got my last lab results which were taken in October, CD4 464, VL 167.
Since I started treatment almost 2 years ago I have only reached undetectable and that was way back in December 2011.
Since then both the CD4 and VL numbers kept fluctuating.
I’m not concerned about my CD4 since it never went down the 300s but on the other hand I am worried that my viral load keeps increasing.
Tests were taken every 3 months with the last test being done after 2 months and my VL results were as follows:
April 2012: 83
August 2012: 123
October 2012: 167
First and second tests were discussed with my ID doctor and he mentioned blips which I knew it could happen but 3 blips in a year, I find that very strange and not very convincing.
Also, my last lab results indicated that my CD4 increased to 464 as opposed to 310 in August. Although this is good, it is still confusing since usually as the CD4 increases the viral load decreases.
Such numbers are freaking me out!
Any words of advice would be much appreciated, please.
Thanks!
Answer
Hello,
Thank-you for your question. I’m sorry to hear that your test results have you worried. Although these viral load test results are still low it is important to find out what is causing this.
A ‘blip’ is defined by the British HIV Association (BHIVA) guidelines as “a detectable VL less than 400, which is preceded and followed by an undetectable result”. So these three detectable results wouldn’t be seen as ‘blips’.
The term used by BHIVA for repeatedly detectable, but low, viral loads is ‘low-level viraemia’. About 8% of people do experience this, so you’re not alone.
Your viral load is still very low, and so your chances of developing resistance are still low. But it’s important to look into what is causing this.
If your viral load remains at this low but detectable level your doctor may want to measure drug absorption levels, or talk about adherence. Some treatment regimes (those based on protease inhibitors) are more likely to be associated with low-level viraemia. Therefore s/he may also want to talk about changing treatment.
Hi Bekezela,
I’m sorry to hear this. What does the doctor say? Do they mean that the results have gone wrong at the lab? It’s important that you talk to the clinic and ask for a valid test for viral load.
Viral load testing tells us whether HIV treatment (ART) is working well.
What country do you live in? If you live in South Africa you can contact the Treatment Action Campaign. They can help with local support.
Never got my viral load results yet, always invalid, started taking medication in December 2017, tested for viral load for about five times now, results always invalid
Hi Pam,
Do you have a copy of your viral load result?
I tested and my viral load results say invalid for two months mow
Hi Jeh84,
Can you ask your medical practicioner why your viral load has been bad? It’s a good idea to ask if you can switch to other meds if the ARVs are not working. After 2 years of ART your viral load should be undetectable and below 50 copies.
Once you’re undetectable you don’t have to be scared if you have sex without a condom. That’s because U=U, please see this link.
You can to talk your doctor about your diarrhoea too. Switching meds can help this.
For the past 2 years my viral load has been bad says my medical practitioner and am scared bc I don’t even go for unprotected sex. I have been having dariah for some time now and with checks nothing discovered. Am so scared. What can I do?
Hi Remi,
Do you mean that your CD4 count is 1107 and viral load is under 20? These results show that your meds are working. You can read about missing doses and being late here. If your wife is not feeling well it’s a good idea for her to have a check up with the doctor.
I use my drugs every day but most time I miss the time by an hour or two I’ve been on unprotected sex with my wife since a year now my result 7 months ago was 1107 &>20.
I’m scared as my + wife is not feeling fine now .is it possible that I’ve infected her with the virus?
Hi,
Your friend can be very pleased with these results. CD4 count shows how well your immune system is doing. A count of 464 is very strong.
Viral load shows how much virus is in your bloodstream. It being undetectable means it is below the level at which tests can easily find it.
As long as your friend keeps taking his medication his viral load should stay undetectable. His CD4 count may also slowly rise more.
My friend has been on ARVs for two years now and he recently had a check up. His blood was taken and sent to the lab. His doctor says he has an undetectable viral load . CD4 is 464. Treatment is working well. He does not know what this means and is afraid to ask.