Question
Why is my viral load undetectable without treatment?
11 March 2014. Related: All topics, CD4 and viral load.
Hello I tested positive twice and both times my viral load is undetectable before starting any ARVs.
Is that possible? And what does that mean?
Thank you
Answer
Hi,
Thanks for your email. It is very unusual to have an undetectable viral load without treatment, but a very small proportion of HIV positive people, known as elite controllers, have undetectable viral loads less than 50 copies/mL for years without treatment. This is very rare and only about 1-in-300 HIV positive people are elite controllers.
It is important to continue to have your viral load monitored, and also to check your CD4 count. The CD4 count measures how strong your immune system is- have you had this test done?
If your CD4 count is high, and your viral load remains undetectable it is unlikely you will need to take ARVs at this time, but it is important to keep being monitored for any changes.
Hi Danny,
That is lucky!
1. It is quite rare to be an elite controller so there’s not much evidence. An elite controller is an HIV positive person whose immune system keeps viral load undetectable for more than five years without medication. But it’s not clear what makes a person an elite controller.
2. HIV medication (ART) is still generally recommended in the long-term. That’s because there is concern that low levels of HIV could still cause acculumlative serious damage to health. Contuining to take ART could be a way of reducing this risk rather than to keep viral load undetectable.
3. With modern ART – which is easier to take and causes fewer side effects – HIV positive people can now have a life expectancy similar to people who are HIV negative.
I am one of the “lucky” elite controllers and have been on medication for the past six months. My viral load was undetectable and CD4 was 370 without medication a year after tested positive. My questions are:
1. what makes the elite controllers? Why their viral load is undetectable without medication?
2. will the HIV medication change the physical situation for the elite controllers, making them dependent on the medication to keep the viral load at an undetectable level?
3. how long can a HIV positive person live with proper medication and treatment?
Many thanks.
Hi B,
I’ll answer your questions in order.
1: It is possible for someone to have an undetecable viral load without medication, these people are called elite controllers. However, being an elite controller isn’t something that’s common. Its very likely that your boyfriend has just been lucky.
2: Once a person stops taking meds their viral load will begin to rebound, it will become detectable again within a week of stopping meds. This is why its important to take meds daily.
3: A CD4 of 489 is good, its within the range of normal for a negative person.
Question1. i am hiv positive and i was not on medication and i was sleeping with my boyfriend for more than 13 months without protection and he tested negative.. Can my viral load be undedactable without medication?
Question 2. Its been two months taking treatment, if i stop can my viral load still be undedactable?
Question 3. When i start treatment my cd4 was 489.. Is it my health bad?
Hi Ahmad,
Because your viral load is undetectable this means that your meds are working. It can take some time for a persons CD4 count to rise to ‘normal’ levels. In time this should happen. Only ARVs can boost a persons CD4 count, so you’re already doing the best thing possible.
Diagnosed hiv positive 6 month ago. Started medications For HIV. Now I m undetectable and continue with medication. My cd4 is not increased. Just sticking around 100 to 150 brackets for last 6 months. When diagnosed with HIV it was 97 cd count.
Does it matter of concern that VL is undetectable state but cd4 not improved satisfactory leve however I feel ok.
Any advice and let me know please how can I boost cd4
Hi Pete,
At the moment there’s not a cure for HIV. So the meds must be taken all the time. Once you start treatment your CD4 count recovers. But this can be different for different people. Sometimes the CD4 count stays on the low side. Being on treatment and undetectable means you’re not likely to get infections. Are you feeling well?
I have been undetectable for at least 10 years I would like to know if I can stop taking my meds I’ve been taking it since 1993 my CD count has always been low right now it’s at 298
Hi Anton,
Everyone who is positive should be on ARVs. This is because only ARVs can control a persons HIV. This is even if their viral load is undetectable. Do you know what his CD4 count is?
My son was recently tested positive for exposure to HIV, he then had a blood test and was found to have an undetectable viral load. The advice I read above was that he shouldn’t need to take drugs however the doctor is putting him on treatment right away. Why is this then, and should we be looking for a second opinion?