Can I Test Hiv Positive If My Viral Load Is Undetectable
You can still test positive for the human immunodeficiency virus even if your viral load is undetectable because you may have a suppressed viral load that cannot be detected, but you still have the virus inside your body.
- As a response to the virus, your immune system produces antibodies against HIV.
- Therefore, a positive antibody test for HIV is possible even if the viral load is undetectable.
Since the beginning of the HIV pandemic, antibody tests were performed to screen for the virus. Antibody tests are the least expensive and most widely used HIV testing. Because they deliver immediate, on-the-spot findings, they are the most often used forms of HIV tests at testing facilities across the world.
Modern diagnostics sometimes combine an antibody test with an antigen or protein assay, providing greater sensitivity for early infection.
Viral Load And Being Undetectable
Medical evidence has shown that people on effective HIV treatment cant pass HIV on.
Viral load is the amount of HIV in the blood.
A viral load test shows how much of the virus is in the body by measuring how many particles of HIV are in a blood sample. The results are given as the number of copies of HIV per millilitre of blood for example 200 copies/ml.
Viral Load And Pregnancy
Taking antiretroviral medications during pregnancy and delivery can greatly reduce the risk of passing HIV on to a child. Having an undetectable viral load is the goal during pregnancy.
Women can take HIV medications safely during pregnancy, but they should talk to a healthcare provider about specific regimens.
If an HIV-positive woman is already taking antiretroviral medications, pregnancy may affect how the body processes her medication. Certain changes in treatment might be needed.
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Never Share Needles Syringes Or Other Drug Injection Equipment
- Use new, clean syringes and injection equipment every time you inject.
- Many communities have syringe services programs where you can get new needles and syringes and safely dispose of used ones. SSPs can also link you to substance use disorder treatment, testing, and care and treatment for infectious diseases.
- Some pharmacies sell needles without a prescription.
How can I protect my baby?
Taking Hiv Medicine To Stay Healthy And Prevent Transmission
HIV treatment involves taking highly effective medicine that reduces the amount of HIV in your body. HIV medicine is recommended for everyone with HIV, and people with HIV should start HIV medicine as soon as possible after diagnosis, even on that same day.
People on HIV treatment take a combination of HIV medicines . A person’s initial HIV treatment regimen generally includes three HIV medicines from at least two different HIV drug classes that must be taken every day. Many people with HIV take two or more different HIV medicines combined in one pill. Long-acting injections of HIV medicine, given every two months, are also available if your health care provider determines that you meet certain requirements.
If taken as prescribed, HIV medicine reduces the amount of HIV in your blood to a very low level, which keeps your immune system working and prevents illness. This is called viral suppression, defined as 200 copies of HIV per milliliter of blood.
HIV medicine can also make your viral load so low that a standard lab test cant detect it. This is called having an undetectable viral load. Almost everyone who takes HIV medicine as prescribed can achieve an undetectable viral load, usually within 6 months after starting treatment. Many will bring their viral load to an undetectable level very quickly, but it could take more time for a small portion of people just starting HIV medicine.
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Hiv Undetectable=untransmittable Or Treatment As Prevention
In recent years, an overwhelming body of clinical evidence has firmly established the HIV Undetectable=Untransmittable, or U=U, concept as scientifically sound. U=U means that people with HIV who achieve and maintain an undetectable viral loadthe amount of HIV in the bloodby taking antiretroviral therapy daily as prescribed cannot sexually transmit the virus to others. Thus, treatment for HIV is a powerful arrow in the quiver of HIV prevention tools. Read more about how a durably undetectable viral load prevents HIV transmission with NIAID’s fact sheet 10 Things to Know About HIV Suppression.
For nearly two decades, scientists have recognized that viral load is a key determinant of HIV transmission. Studies conducted before the availability of ART revealed that higher viral loads correlate with higher rates of both sexual and perinatal transmission of HIV. Following the advent of triple-drug ART in 1996, observational studies suggested that viral loads lowered by ART were associated with reduced risk of sexual and perinatal HIV transmission. In addition, epidemiological studies showed that as the number of people in a community who are virally suppressed rises, the number of new HIV transmissions falls.
To read more about the underlying science and the value of U=U, see NIAIDs blog post Science Validates Undetectable=Untransmittable HIV Prevention Message.
What Does It Mean To Have Undetectable Hiv
Undetectable viral load is a phrase you will likely hear a lot this week. Early Tuesday morning after a day of rumors online Charlie Sheen announced liveon the Today show that he is HIV-positive, but that treatment has rendered the virus undetectable in his blood.
Undetectable is not cured, as Sheens physician, Dr. Robert Huizenga, noted on the show. But it does mean that the anti-retroviral treatment isworking, and that the amount of HIV in the blood is so low that even the best available tests dont pick it up. As its usually defined now, to have an undetectable viral load means there are fewer than 20 copies of the virus in one milliliter of blood. Compare that to those who have just been diagnosed and not yet treated, whose tests show millions of copies in the same sample size.
The very latestresearch is showing that it is highly unlikely for people with an undetectable viral load to transmit the virus to a sexual partner even without the use of a condom. Individuals who are optimally treated who have undetectable viral loads, who responsibly use protection have an incredibly low its incredibly rare to transmit the virus, Huizenga told Todays Matt Lauer. Indeed, this summer, theresults of a large international study showed that early treatment reduces the risk of transmission by 93 percent. We cant say that thats zero, Huizenga said, but its a very, very low level.
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Testing Positive On Nucleic Acid Tests
In addition to antibody tests, we also have HIV tests that detect viral RNA not necessarily live virus, but parts of the virus genetic material. These are called nucleic acid tests, and they are able to detect very early HIV infections. These tests are not used as often for screening as antibody tests , because results take longer and the test is more expensive. Usually, RNA tests are used to confirm an HIV positive diagnosis after someone tests positive on an antibody test or to see if a person is responding well to treatment.
Some of these viral detection tests are able to detect virus at very low levels. Some research HIV RNA assays can measure HIV RNA levels down to the single copy levels.
We commonly say someone is undetectable if they have a viral load less than 20 copies/mL or 50 copies/mL. Research studies have defined undetectable as any viral load less than 200 copies/mL.
So even if a person has a viral load less than 50 copies/mL or 20 copies/mL, viral RNA will still be detected with one of these viral detection tests.
Does Undetectable Viral Load Imply That There Is No Hiv In The Body
When you are diagnosed with human immunodeficiency virus , you must undergo blood sampling two to four times each year to evaluate the virus levels in your blood. A viral load test determines how much virus is present in the body by counting the number of HIV particles in a blood sample. Results are expressed as the number of HIV copies per milliliter of blood, for example, 200 copies/mL.
HIV therapy reduces the viral load in the blood, and when the viral load is less than 20 copies/mL, then it is said to be an undetected viral load.
- ARV therapy successfully reduces the viral load to undetectable levels. If the drug is not taken as directed, the viral load increases once more.
- The virus continues to replicate itself and damages immune system cells. This process will eventually develop into a full-blown acquired immunodeficiency syndrome , a serious disorder in which the body’s immune system is unable to fight common infections caused by viruses and bacteria.
Fortunately, the treatment is now so effective that HIV does not progress to AIDS. That implies that even if you have HIV, you can live your life as per your choice, without fear of the infection. When HIV is identified early and treatment is effective, your life expectancy is almost similar to that of the general population.
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Testing Positive On Hiv Antibody Tests
Since the early days of the HIV epidemic, we have used antibody tests to test for HIV. Antibody tests are the most affordable and accessible HIV tests. They are the most common types of HIV tests at testing sites around the world because they provide rapid, on-the-spot results.
Antibody tests do not detect HIV. Instead, they detect antibodies that the immune system produces in response to HIV infection.
Want to know more about different types of HIV tests, how they work and how early they detect HIV? Check out thiseasy-to-read guide from Avert orread this Q& A by the CDC.
WHAT ARE ANTIBODIES?
Our immune systems develop antibodies in response to all kinds of pathogens. Anytime you get sick or get any kind of infection, your body builds up a defense system and creates antibodies to try and fight that specific infection off. If these antibodies are successful, some infections will go away but the antibodies never do. They will remain in your body, helping to protect you from getting the same infection in the future.
In this way, antibodies allow our bodies to remember a specific infectious agentlike a particular strain of the fluand then respond to it more quickly if exposed to it again in the future. Once we develop antibodies to a virus we may have those antibodies for life or for many years.
HIV ANTIBODIES
HIV ANTIBODIES WHEN YOURE UNDETECTABLE
Dont Breastfeed Your Baby
- Do not breastfeed your baby, even if you have an undetectable viral load. Having an undetectable viral load reduces the risk of transmitting HIV to the baby through breastfeeding but doesnt eliminate the risk.
- The current recommendation in the United States is that mothers with HIV should not breastfeed their babies.
You should also have a pelvic examination and get tested for other sexually transmitted diseases during your pregnancy.
If I have an undetectable viral load, do my partner and I need to use anything else to prevent sexual transmission of HIV?
Getting and keeping an undetectable viral load prevents HIV transmission during sex. But there are situations when either partner may want to use additional prevention options.
- Using condoms can help prevent some other STDs.
- Using condoms or having your partner take PrEP can provide added peace of mind.
- Also consider using additional prevention options if you
- Are unsure, for any reason, that you have an undetectable viral load
- Have a high viral load
- Have trouble taking HIV medicine regularly
- Missed some doses since your last viral load test or
- Have stopped taking HIV medicine or may do so in the future.
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No Risk Of Hiv Transmission Really
So is it true that if a HIV positive partner is on treatment and has a UVL sustained , then there is no risk of HIV transmission?
Yes!
In 2016, the PARTNER study from Europe found that the chance of HIV transmission where one partner had a UVL is negligible. In fact, there were zero partner-transmissions recorded in the study despite approximately 22,000 acts of condomless sex by gay couples. Additionally, PARTNER2 the extension study of PARTNER that aimed to gather data pertaining to mixed-HIV-status gay male couples found that after an additional 54,000 acts of condomless sex there were zero transmissions.
This is also supported by a large international study, led by the Kirby Institute here in Australia, the Opposites Attract study, which focused solely on gay and other men who have sex men from Australia, Brazil and Thailand, confirmed that HIV positive men who are on treatment and have an undetectable viral load do not transmit the virus to their partners.
So, between these two studies there has was a combined total of over 89,000 acts of condomless sex occurred between gay couples with zero transmissions!
What About Sexually Transmitted Infections
It is important to remember that while HIV treatment will protect your partners from your HIV, it does not protect them or you from other sexually transmitted infections . For this reason, regular sexual health check-ups are recommended. Using condoms will help prevent STIs.
Another concern is whether having a STI could lead to an increase in viral load. This does happen to people with HIV who are not taking treatment: for instance, syphilis can double your viral load. HIV-negative partners are also more likely to get HIV if they have an STI.
But it is not the case for people taking HIV treatment who have an undetectable viral load. In the PARTNER and Opposites Attract studies, there was not a single HIV transmission even though many people had STIs.
If you maintain good adherence to HIV treatment, catching an STI will not raise your viral load from undetectable to detectable. Effective treatment prevents sexual transmission of HIV even if there are other STIs present.
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What Makes Someone Hiv
HIV is a virus that attacks cells in the immune system, killing them and leaving the body defenseless against infection. It is transmitted through contact with infected blood, semen, or vaginal fluids.
Once HIV enters the body, it introduces an antigen called p24. This is a viral protein that prompts the immune system to activate white blood cells. On alert that the virus is present, the immune system then starts producing antibodies, proteins that help fight off infection.
The presence of HIV antigens or antibodies in blood, saliva, or urine confirms that someone is HIV-positive. This is detected through an HIV test.
Cdc Backing Could Help Lessen Stigma
Misinformation, stigma, and fear around HIV remains prevalent.
People diagnosed with HIV overestimate the risk of infecting their HIV-negative partner. Even though only 10 percent of participants in a recent survey had non-suppressed viral loads, a third of respondents believed their chance of infecting a partner was high, according to AIDSMAP.
We hope the CDCs endorsement of this fact helps lessen the stigma that still exists around people living with HIV, and that it encourages an open dialogue between sexual partners about their status, treatment, and prevention methods, said Sawyer.
Prevention Access Campaign has been a leader in education around the issue with the U=U campaign.
Advocates also hope the CDCs backing will provide additional leverage for challenging state nondisclosure laws, which criminalize HIV-positive people who dont disclose their HIV status.
Sawyer pointed out, The CDCs acknowledgement is a further indication that our laws around nondisclosure are no longer supported by the current accepted science and research about HIV transmission.
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How Often Should I Have My Viral Load Tested
This is something you should discuss with your doctor. A basic guide to viral load testing is to have it done every 3 to 6 months. If, however, you are relying on being undetectable as your primary means of HIV prevention, you may want to consider testing your viral load more frequently. To find out more about this talk to your HIV specialist.
What Does A Viral Load Of 200 Mean
When the viral load reaches less than 200 copies/ml of blood, doctors consider that HIV is undetectable. Though copies of the virus remain in the blood, undetectable levels mean that a person cannot transmit the virus to others. When people achieve this, they can live the same quality of life as those without HIV.
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What Does ‘treatment As Prevention’ Mean
Treatment as prevention refers to the use of HIV medication to reduce the risk of HIV transmission at a community level. If everyone living with HIV was diagnosed, started treatment immediately and was able to maintain an undetectable viral load, there would be no sexual transmission of HIV. In this way treatment would become a form of prevention.
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.
“For as long as your viral load stays undetectable, your chance of passing on HIV to a sexual partner is zero.”
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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