What does undetectable viral load mean?
Undetectable…it is mentioned in scientific journal articles, voiced at Aids campaigns, discussed at conferences and explained to people with HIV in clinics. It is something that people with HIV, especially those on ARVs aspire to. An “undetectable” viral load means the amount of virus in a person’s blood is so low that it cannot be measured by most tests.
Viral load only measures HIV in the blood, the amount of HIV in other body fluids, semen, vaginal fluid and breast milk may be different. Tests for viral loads have a cut-off point in which they can reliably detect HIV. This is called the limit of detection. For most tests, a viral load below 50 copies/ml is considered undetectable. The aim of HIV treatment is to reach an undetectable viral load. This does not mean a person is cured or that there is no virus in body. What it does mean is that the HIV is under control and the treatment is working.
If viral load becomes undetectable that does not mean treatment should stop. Even though the virus is undetectable in the blood, it is still hidden in other parts of the body, such as the brain, reproductive organs, and lymph nodes. If treatment is stopped, the virus will start reproducing again and viral load will increase, putting health at risk.
An undetectable viral load is good for a number of reasons. Firstly, a stronger immune system means less risk of getting sick from opportunistic infections. Secondly, an undetectable viral load means a lower risk of becoming resistant to antiretroviral drugs. And finally, an undetectable viral load reduces the risk of passing HIV to someone else. However, the presence of sexually transmitted infections influences transmission of HIV when viral loads are undetectable.
People with high viral loads in their blood may also have high viral loads in their semen and vaginal fluid. That makes them more infectious with transmission to someone else more likely. However, it is not scientifically clear whether having an undetectable viral load completely removes the risk of passing on HIV.
People with undetectable viral loads may experience undetectable viral load blips. When the viral loads goes undetectable to detectable and back to undetectable. These blips do not necessarily mean that the drugs are not working. These blips can be a result of testing procedures or influenced by infections such as cold or flu.
CD4 cell count is the main indicator of the health of the immune system. Doctors will look at CD4 cell count and viral load together, if viral load tests are available, in order to determine treatment plans and monitor disease progression. To attain an undetectable viral load, one must take antiretroviral medications regularly and live a positive, healthy lifestyle.
