In today’s blog, we wanted to talk about the concept of an ‘undetectable’ viral load. This is in response to some of our members asking for clarification on what the terms means, and on what having an undetectable viral load means for people living with HIV. If you’d like any more information, please contact us.
What do my blood tests mean?
If you have been diagnosed with HIV you will be advised to attend the hospital for regular check ups. At these check ups your medical team may keep an eye on your blood pressure and weight. You may be offered sexual health tests. You will also have your blood taken. These blood tests help your doctors to keep an eye on your kidneys, liver, cholesterol, glucose and also look for other problems. Two important tests that are done regularly are your CD4 count and your viral load.
Your CD4 count is a measure of how many CD4 cells are in your blood. These are cells that fight off infections. CD4 cells are the cells that are infected and damaged by HIV. You will find that your CD4 count varies a lot from test to test. This should not worry you. The key is to look at the general trend and see if it is falling. Current recommendations in the UK are that you should consider starting HIV treatment to control your HIV and improve your immune system when your CD4 count is approaching 350 cells/mm3 or below. People with CD4 counts below 200 cells/mm3 may be at greater risk of infections and other complications and may be advised to take other medicines to help prevent these as well as HIV treatment. Once you start HIV medication your CD4 count will increase but it may take months to years to get back to normal. In the meantime your immune system will get stronger and stronger.
Your viral load is a measure of how much virus you have in 1ml of your blood. Again, it is common to see fluctuations in viral load when people are not on treatment. Your viral load may increase if you have an infection like flu or a vaccination. This is not thought to be harmful. An important reason to check viral loads is to see how people are responding to HIV treatment. HIV treatment works by stopping the virus from reproducing. The current goal of treatment is to control the level of virus to less than 40 copies/ml. This means that the virus is there but at extremely low levels and it cannot be seen with current tests. This is known as UNDETECTABLE.
Being undetectable on treatment is good. It means that your virus is well controlled and less likely to cause problems to your health. It also shows that your medicines are working well and that you are unlikely to develop resistance. However it is important to remember that undetectable does NOT mean that the HIV has gone completely. It is still present in parts of the body in small amounts. This is why it is important to carry on taking your medication as it will keep the HIV under control. It is also advisable to continue to use condoms during sex. Although the risk of passing on HIV is reduced if you have an undetectable viral load, the risk is not eliminated completely. You may also put yourself at risk of other infections if you do not protect yourself with a condom. As always, if you have any questions you should feel free to ask your clinic doctor.
Here are some links if you want to read more about CD4 and viral load: