Undetectable (viral load)

A successful treatment with HIV medication will ensure that the amount of virus in your blood (i.e. your viral load) will go down. After six months at most, your viral load will become undetectable. Your immune system will recover and thanks to the successful treatment, there will be very little chance of your transmitting your HIV to others. Nevertheless there may be situations in which your HIV will become temporarily detectable.

Undetectable viral load

If you are not being treated for HIV there will be thousands if not millions of virus particles (copies) in every cubic millilitre (mm3) of your blood. The goal of treatment is to reduce the amount of HIV in your body (i.e. your viral load) until the virus can no longer be measured in your blood – even with the most refined equipment. If the amount of HIV in your blood is no longer measurable, your viral load is undetectable. Undetectable means that you have fewer than 50 copies of the virus per mm3 of blood. Once your viral load has become undetectable, you will be checked every three to six months to make sure it stays that way.

Why is having an undetectable viral load so important?

  • It gives your immune system a chance to recover and regain strength.
  • It prevents you from becoming ill as a result of your HIV.
  • It practically eliminates your chances of passing on your HIV to your sex partner (unless you happen to have an STI).
  • It practically eliminates your chances of becoming reinfected with a different strain of HIV, including one that may be resistant to your medications.

STIs and viral load

Some scientists currently assume that STIs may temporarily increase the amount of HIV in anal secretions and sperm. That could increase your chances of transmitting your HIV, even if you are being successfully treated with HIV medications. Nothing would be visible in your blood: the virus would still be unmeasurable there. Do you (sometimes) not use condoms with your steady partner or with casual sex partners?  If you or your partner has an STI, there is still a risk that HIV could be transmitted (despite an undetectable viral load).

Temporary rises (blips)

During the treatment it could happen that your viral load becomes temporarily detectable. Usually that involves a slight rise in the number of virus particles. Such a brief change is known as a “blip”. There is no need for immediate concern. A blip does not always mean that your medications are no longer working. The next time your viral load is measured, it could easily be undetectable again. The reason for a blip could be that your viral load measurement was done inaccurately, for example. Doctors refer to that as “lab contamination”. To rule that out, you may need to have blood drawn again for an extra test.

Scientists don't know if every blip presents a danger in terms of the transmission of HIV. For example, it is not known how much your viral load would need to rise before you run a risk of infecting your sex partner.

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