What Level of Viral Load Is Undetectable?
A viral load tests count the number of human immunodeficiency virus (HIV) copies per milliliter of blood.

An undetectable human immunodeficiency virus (HIV) viral load is defined as less than 20 copies of HIV per milliliter of blood.

Many HIV tests may not detect the virus if there are fewer than 50 copies per mL of blood. However, modern tests such as reverse transcription-polymerase chain reaction are quite effective and can detect a viral load as low as 20.

  • A low viral load is achieved by taking proper HIV medicine that reduces the amount of HIV in the body to a very low level. This is known as viral suppression.
  • The aims of antiretroviral treatment (ART) are always viral suppression and an undetectable viral burden.
  • This does not imply that there are no viruses in your body; rather, the amount of viruses is insufficient for the test to detect and count.

People with HIV who attain and maintain an undetectable viral load are unable to transmit HIV to their sexual partners. It is very important to continue taking ART as directed to keep the virus undetectable.

What is viral load?

The viral load test determines the level of the human immunodeficiency virus (HIV) in your blood. It is the recommended method of determining whether antiretroviral treatment is effective. The test counts the number of copies of HIV in 1 mL of blood.

Viral load test results assist your healthcare professional in tracking the progression of your infection, determining if your HIV therapy is effective, and making treatment decisions.

Keeping your viral load low will help your immune system stay healthy, reduce the likelihood of problems such as opportunistic infections, and help you live longer. If you stick to your treatment plan, you may be able to live a productive and healthy life.

How to test for viral load

Human immunodeficiency virus (HIV) viral load assays check for ribonucleic acid (RNA), the portion of HIV that contains the instructions for replication. To create extra copies of the RNA, the tests include an enzyme, which is a type of protein. This makes determining the amount of HIV in your blood sample easier.

These reverse transcription-polymerase chain reaction techniques are far more sensitive than previous HIV testing. In a milliliter of blood, they can discover as few as 20 copies of HIV RNA.

Because tests made by various manufacturers may produce slightly varied results, your healthcare professional must use the same HIV viral load test each time. Fluctuations in the viral load should be due to ongoing changes in your body but not because of a different testing procedure. New tests and more sensitive methods for detecting viral load are being developed by scientists.

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What are the results of viral load tests?

A viral load tests count the number of human immunodeficiency virus (HIV) copies per milliliter of blood. Based on the number of copies, the tests are categorized into three types.

  1. High HIV viral load:
    • A high HIV viral load is commonly defined as more than 100,000 copies per milliliter of blood; however, it might be one million or more.
    • The virus is replicating itself, and the sickness might spread swiftly.
  2. Lower HIV viral load:
    • A lower HIV viral load is defined as less than 10,000 copies per milliliter of blood.
    • The virus is presumably not actively multiplying as quickly, and immune system harm may be reduced, but this is not ideal.
  3. Undetectable HIV viral load:
    • An undetectable HIV viral load is defined as less than 20 copies per milliliter of blood.
    • Your viral load result may occasionally shift from undetectable to a low level (usually fewer than 400 copies/mL) and then back to undetectable. These blips are commonly seen even if you are being effectively treated for HIV. These blips do not indicate treatment failure or the development of resistance by the virus.

What are the limitations of viral load test?

A viral load test is a blood test; therefore, it can detect only the virus present in your blood. 

  • Your blood contains only 2 percent of the total human immunodeficiency virus (HIV) virus in your body.
  • The remaining viral load is present in bodily tissues such as the lymph nodes, spleen, or brain, which cannot be detected through viral load tests.
  • HIV levels in lymph tissue and sperm decrease as blood levels decrease, although not at the same time or rate.

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Medically Reviewed on 6/1/2022
References
Image Source: iStock image

What Does HIV Viral Load Tell You? https://www.webmd.com/hiv-aids/hiv-viral-load-what-you-need-to-know

What is HIV undetectable? https://www.greaterthan.org/videos/what-is-hiv-undetectable/