What Is An Undetectable Viral Load
FAST FACTS
- Taking antiretroviral treatment reduces the amount of HIV in your body.
- With proper adherence, ART can reduce HIV to such low levels that the virus can no longer be detected in normal blood tests. This is called having an undetectable viral load.
- People with undetectable viral loads cant pass HIV on through sex.
- To know that youre undetectable, you must have your viral load monitored regularly.
- Remember your viral load can change. If you stop taking your treatment properly your viral load will go up again.
What Are Aids And Hiv
AIDS is the disease caused by human immunodeficiency virus type 1, or HIV-1 . HIV belongs to the retrovirus family, a group of viruses that have the ability to use cells’ machinery to replicate .
HIV attacks the immune system by damaging or killing a specific type of white blood cell in the body called a T-lymphocyte , also called a CD4+ or T-helper cell. T-lymphocytes help the immune system perform its important task of fighting disease in the body caused by invading germs. As a result of HIV infection, the immune system becomes weakened and the body has trouble battling certain infections caused by bacteria, viruses, parasites, and fungi. Many of these infections are highly unusual in people with healthy immune systems. They are called opportunistic infections because they take advantage of a weakened immune system. People with HIV disease not only are more likely to contract these infections, they are more likely to have them repeatedly and to become much more sick from them.
* immune system is the system of the body compose d of specialized cells and the substances they produce that helps protect the body against disease-causing germs.
Infection with HIV takes about 10 years to develop into full-blown AIDS. During most of this period, people usually look and feel healthy
What Is Viral Suppression
Antiretroviral therapy keeps HIV from making copies of itself. When a person living with HIV begins an antiretroviral treatment regimen, their viral load drops. For almost everyone who starts taking their HIV medication daily as prescribed, viral load will drop to an undetectable level in six months or less. Continuing to take HIV medications as directed is imperative to stay undetectable.
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Frequently Asked Questionsexpand All
If you are thinking about taking PrEP, you will be tested for HIV. If you are infected with HIV, you will need HIV treatment. If you are not infected, your obstetriciangynecologist may prescribe PrEP.
You must take a pill once a day. Missing doses can lower the medications effectiveness and put you at risk of HIV infection.
The most common side effects of PrEP include
stomach pain
weight loss
nausea and diarrhea
These side effects usually go away on their own after a few weeks. Serious side effects of PrEP include liver problems and a condition called lactic acidosis, which happens when there is too much acid in the blood.
PrEP by itself is not guaranteed to prevent HIV infection. You also need to follow safe sex practices while taking PrEP:
Know your sexual partners and limit their numberYour partners sexual history is as important as your own. The more partners you or your partners have, the higher your risk of getting HIV or other STIs.
Use condomsUsing a latex or polyurethane condom every time you have vaginal, oral, or anal sex decreases the chances of HIV infection.
Talk with your ob-gyn about how to prevent infection. Steps to prevent HIV infection include the following:
Your partner should have treatment for HIV infection .
Dealing With Feelings Of Blame
Sometimes when people find out theyre HIV positive they want to blame someone. These feelings are completely natural and understandable.
Some young people might be tempted to stop taking their medication or seeing their doctor in order to stop thinking about their HIV. This is very dangerous and very likely to result in serious health problems.
If you find HIV too difficult to deal with, you can contact THT Direct on 0808 802 1221.
You can also get in touch with Body and Soul in London or CHIVA nationwide. They provide services to children, teenagers, young people and their families if someone in the family is living with HIV. This included support groups especially for children and young people.
If you find youre struggling with any aspect of living with HIV, please ask for help. Theres lots of support out there.
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How Will I Know If I Am Undetectable
You cant tell if you have an undetectable viral load simply by how healthy you look and feel. The only way to know that your viral load is undetectable is by regular viral load monitoring.
Viral load monitoring involves a simple blood test to measure how many particles of HIV there are in a small sample of your blood . From this you and your healthcare worker can understand how well your ART is working.
A low viral load means that your ART is working well and controlling your HIV. If you have an undetectable viral load, it means that the amount of HIV in your body is so low that you can’t pass it on to other people through sex.
The point at which a viral load is classified as being undetectable may vary across different countries depending on the tests available. But so long as your viral load is under 200 copies per millilitre, youre considered virally suppressed and unable to pass HIV on.
The frequency with which you are offered viral load testing may vary depending on where you are and the services available to you. The World Health Organization recommends that when first starting ART, you should have your viral load measured after the first 6 months of treatment and again at 12 months. After becoming undetectable you should still receive viral load testing at least every 12 months. Depending on the resources available and your particular health status, your health worker may recommend that your viral load is monitored more often than this.
Does Being Durably Undetectable Mean That The Virus Has Left My Body
Even when viral load is undetectable, HIV is still present in the body. The virus lies dormant inside a small number of cells in the body called viral reservoirs. When therapy is halted by missing doses, taking a treatment holiday or stopping treatment, the virus emerges and begins to multiply, becoming detectable in the blood again. This newly reproducing virus is infectious. It is essential to take every pill every day as directed to achieve and maintain a durably undetectable status.
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What Is The Connection Between Hiv And Hbv
Both HIV and HBV spread from person to person in semen, blood, or other body fluids. For this reason, the main risk factors for HIV and HBV are the same: having sex without a condom and injection drug use.
According to the Centers for Disease Control and Prevention , approximately 10% of people with HIV in the United States also have HBV. Infection with both HIV and HBV is called HIV/HBV coinfection.
Chronic HBV advances faster to cirrhosis, end-stage liver disease, and liver cancer in people with HIV/HBV coinfection than in people with only HBV infection. But chronic HBV does not appear to cause HIV to advance faster in people with HIV/HBV coinfection.
How Do I Know If My Viral Load Is Undetectable
The only way to know if your viral load is undetectable is through an HIV viral load or HIV RNA test that your doctor or health care provider can do. You will need to have your blood drawn for this test, and the test will determine the level of virus in your blood that day. If the level of virus in your blood is below the limit of detection of the test, then we say your virus is undetectable.
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Too Many Gay And Bisexual Men Are Not Receiving Treatment Warns Us Body
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The Centre for Disease Control has declared that HIV-positive people taking effective medication to suppress the virus cannot pass it on through sex, and that it will update its guidelines accordingly.
The landmark step by the US public health institute follows years of clinical trials showing that those using effective anti-retroviral therapy do not risk infecting their sexual partners.
Activists and researchers have long campaigned for the CDC to make the declaration, but they had declined to do so.
Can Hiv/aids Cause Other Medical Complications
Complications include AIDS-related opportunistic infections invasive bacterial infection certain cancers such as non-Hodgkin’s lymphoma, Kaposi’s sarcoma, and cervical * cancer pneumonia and AIDS dementia , in which there is impairment of thinking, memory, and concentration. HIV-infected people who use IV drugs are at increased risk for hepatitis * C infection, which can lead to severe liver damage and death. People with AIDS also are more likely to develop more severe symptoms and complications from other infections such as syphilis * and tuberculosis * .
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Hiv During Pregnancy And Childbirth
Women living with HIV who are on treatment and have a stable undetectable viral load are extremely unlikely to transmit HIV to their baby during pregnancy and childbirth. There is a 1 in 1000 chance of transmitting HIV to the baby during pregnancy and delivery, when a woman is on antiretroviral treatment and has a viral load below 50 copies/ml .
HIV-positive women who are on treatment and have stable undetectable viral load, have a 1-2% chance of transmitting HIV to their baby if they breastfeed for 12 months.
So, although it is unlikely that a woman will transmit HIV to her baby when breastfeeding it is currently advised not to breastfeed.
How Hiv Affects The Body
HIV attacks the immune system. It specifically attacks the CD4 cells, which are a subtype of a group of cells called T cells. T cells help the body fight off infections.
Without treatment, HIV reduces the number of CD4 cells in the body, increasing a persons risk of getting infections. If HIV develops to stage 3, the person will also have a higher chance of developing cancer.
The Centers for Disease Control and Prevention provide information on where people can find their nearest HIV testing center.
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In What Circumstances Is Mother
There are complex reasons why children may be at a greater risk of HIV infection in poorer countries. Some may not have very good medical facilities, or it might be hard to offer people good medical care.
Some mothers-to-be dont find out about their HIV while theyre pregnant or breastfeeding. Others might find it hard to cope or have no way of accessing the medical help that they need.
Sometimes its just not possible to prevent HIV being transmitted from a mother to her baby.
How Do We Know Treatment As Prevention Works
Large research studies with newer HIV medications have shown that treatment is prevention. These studies monitored thousands of male-female and male-male couples in which one partner has HIV and the other does not over several years. No HIV transmissions were observed when the HIV-positive partner was virally suppressed. This means that if you keep your viral load undetectable, there is effectively no risk of transmitting HIV to someone you have vaginal, anal, or oral sex with. Read about the scientific evidence.
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What Is The Risk Of Hiv From Anal Sex
The risk of HIV through unprotected anal intercourse is seen to be extremely high, as much 18 times greater than vaginal intercourse. The reasons for the increased risk are well known and include such factors as:
- The fragility of rectal tissues, which allow the virus direct access into the bloodstream through tiny tears or abrasions
- The porousness of rectal tissues, providing access even when undamaged
- The high concentration of HIV in semen and pre-seminal fluid , which doubles the risk of infection with every one-log rise in the person’s viral load.
Furthermore, the secretion of blood from damaged rectal tissues can increase the risk for the insertive partner, providing the virus a route of transmission through the urethra and tissues that line the head of the penis .
Strategies To Reduce Risk
As with any other mode of HIV transmission, prevention requires a combination of strategies to more effectively:
- Reduce the infectivity of the HIV-positive partner
- Reduce the susceptibility of the HIV-negative partner
Current evidence has shown that the consistent use of antiretroviral therapy in the HIV-infected partner completely eliminates the risk of HIV transmission when viral activity is suppressed to undetectable levels.
The effectiveness of the strategy known as Treatment as Prevention , is evidenced by the PARTNER1 and PARTNER2 studies in which not a single HIV infection occurred among 1,770 gay and heterosexual mixed-status couples despite engaging condomless anal or vaginal sex.
The studies, which ran from 2010 to 2018, showed unequivocally that undetectable equals untransmittable in a real-world setting.
The use of pre-exposure prophylaxis , whereby the uninfected partner is prescribed a daily dose of the HIV drug Truvada, can also reduce risk. Studies have shown that when taken daily, PrEP reduces the risk of getting HIV from sex by about 99%.
Although these figures may suggest that condoms are no longer needed, neither TasP nor PrEP can prevent other sexually transmitted diseases.
Moreover, according to the Centers for Disease Control and Prevention , only 59.8% of Americans with HIV are able to achieve an undetectable viral load. Without complete viral suppression, TasP is rendered useless, placing the uninfected partner at risk.
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Keep Taking Your Hiv Medication To Stay Undetectable
HIV is still in your body when your viral load is suppressed, even when it is undetectable. So, you need to keep taking your HIV medication daily as prescribed. When your viral load stays undetectable, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex. If you stop taking HIV medication, your viral load will quickly go back up.
If you have stopped taking your HIV medication or are having trouble taking all the doses as prescribed, talk to your health care provider as soon as possible. Your provider can help you get back on track and discuss the best strategies to prevent transmitting HIV through sex while you get your viral load undetectable again.
What Does It Mean To Be Durably Undetectable
Taking antiretroviral therapy daily as prescribed to suppress HIV levels leads to an undetectable status. A person is considered to have a durably undetectable viral load if their viral load remains undetectable for at least six months after their first undetectable test result. It is essential to continue to take every pill every day as directed to maintain an undetectable viral load.
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Stage : Acute Hiv Infection
Soon after a person contracts HIV, they may develop flu-like symptoms. These symptoms typically appear within and may last for several days or weeks.
The symptoms of an acute HIV infection can include:
- a skin rash that usually does not itch
- muscle aches
- swollen glands in the throat, groin, or armpits
- sores or ulcers in the mouth or genitals
- nausea, vomiting, or both
This is known as a seroconversion illness. Seroconversion is when the body begins to produce antibodies against the virus. This is the bodys natural response to detecting an infection.
At this stage, the virus replicates rapidly. The person has a large amount of HIV in their blood, and the risk of transmitting the virus to others is high.
Not everyone develops symptoms at this stage. Others experience mild flu-like symptoms that go largely unnoticed. This means that people may contract HIV without knowing it, which makes testing very important.
If a person thinks they may have been exposed to HIV, it is important to talk to a healthcare provider for advice, and to ask them about preventative medication called post-exposure prophylaxis .
Healthcare providers can order tests to check for HIV. can detect the virus after 10 days, while others may not detect the infection until 90 days after exposure. People often need to take more than one test for accurate results.
How Do I Explain This To A Sexual Partner
If you have sexual partners who are not living with HIV, explaining U=U to them is likely to be mutually beneficial. If you had previously relied on other means of preventing HIV transmission , you may jointly decide that these methods are no longer necessary because of U=U.
It may take some time for an HIV-negative partner to accept the U=U message and to rely on it as the sole method of preventing HIV. Some HIV-negative people may reject the message or deny its accuracy. It may be helpful to direct your partner to information resources that explain the accuracy and significance of U=U. NAM has also produced a page for people who dont have HIV to help them understand the impact of an undetectable viral load on HIV transmission.
Another option could be for your partner to hear about U=U from a healthcare worker or another reliable and trusted source.
Despite sharing this information, some people may still not accept that U=U. In this kind of situation, it is important to find a balance between providing your partners with information and taking care of yourself.
Many people find it difficult to talk about sex, even with the person who is closest to them. If this is the case, you might want to discuss your concerns with someone at your HIV clinic, sexual health clinic or a support organisation. This can help you clarify your thoughts and what youd like to say.
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