Undetectable HIV: Viral loads, treatments, and safe practices - Medical News Today

There is currently no cure for HIV. However, treatment can improve health and reduce the virus to levels where it is undetectable and untransmissible.

HIV is a virus that weakens the immune system and increases the risk of contracting other infections and diseases. HIV attacks CD4 cells, a type of white blood cell that normally helps the body fight infections.

HIV overtakes CD4 cells to create more copies of itself, destroying the host cell. This allows the virus to spread while weakening the body's immune system. Some people may develop symptoms 2–4 weeks after contracting HIV. These may last for a few days to a few weeks and can include:

• fever
• tiredness
• rash
• muscle aches
• sore throat
• swollen glands in the throat, groin, or armpit
• nausea, vomiting, or both

HIV can worsen without treatment and cause additional complications. For instance, HIV can develop into AIDS, where the immune system is severely damaged. People with AIDS are vulnerable to many infections and can become life-threateningly ill.

Doctors use blood tests to check for the presence and severity of HIV. One of these tests is for viral load, which measures how many copies of HIV are present in a milliliter of blood.

People with HIV typically have a detectable viral load before they start treatment. The aim of treatment is to reduce the viral load as much as possible, which doctors call viral suppression.

There is currently no cure for HIV. However, treatment can lead to an undetectable viral load. This is where the virus is present in such small quantities that it causes few problems and does not transmit to others.

Keep reading to learn more about undetectable viral loads.

The Centers for Disease Control and Prevention (CDC) state that an undetectable viral load is when someone has fewer than 200 copies of HIV per milliliter of blood. Blood tests can typically still detect anything above 200 copies.

The main goal of treatment is to reach and maintain an undetectable viral load. Antiretroviral therapy (ART) involves taking several drugs that prevent HIV from replicating. They reduce the viral load to give the immune system a chance to produce more CD4 cells and fight off infections.

Antiretroviral drugs cannot completely remove HIV from the body. However, reducing the viral load to undetectable levels effectively prevents someone from passing HIV to others during sex. People must continue taking daily antiretroviral drugs to maintain an undetectable viral load.

People undergoing antiretroviral therapy will typically receive a viral load test at 6 and 12 months after starting treatment. A doctor will recommend going for a viral load test at least every 12 months after that.

People experiencing symptoms or health problems related to HIV should start improving after reaching an undetectable viral load. At that point, the immune system will typically be strong enough to fight off infections and diseases.

It is worth noting that some people with HIV may be unable to reach an undetectable viral load. This may include those who are taking other drugs that interact with antiretroviral therapy. In these cases, people will require additional precautions and health checkups.

The CDC states that there is effectively no risk of someone with an undetectable viral load transmitting HIV to a partner through sex. However, it is still possible to pass on other sexually transmitted infections, such as:

People with an undetectable viral load should still follow safe sex practices. The American College of Obstetricians and Gynecologists suggests reducing the risk of these infections by:

• reducing the number of sexual partners
• using latex or polyurethane condoms
• being aware of the increased risk with certain sexual practices, such as anal sex
• getting vaccinated against hepatitis B and HPV

People can also pass on HIV through other practices involving an exchange of bodily fluids, such as sharing needles and syringes.

The CDC states that it remains unclear whether people with undetectable viral loads can still transmit the virus by sharing needles and syringes. However, the risk will still be substantially lower than with someone who has a detectable viral load.

The organization recommends that women with an undetectable viral load avoid breastfeeding. Although the chances of transmitting HIV to the baby are very low, they are not zero.

People with undetectable viral loads must continue taking antiretroviral therapy. The drugs suppress HIV to protect the immune system. Stopping or reducing antiretroviral therapy will give the virus a chance to accumulate and weaken the immune system again.

An undetectable viral load is where the number of HIV copies is too low for detection by blood tests. This typically means fewer than 200 copies of HIV per milliliter of blood. The aim of antiretroviral treatment is to reach and maintain an undetectable viral load.

People with low levels of HIV in the blood experience fewer health problems and are able to engage in sexual activities with almost no risk of passing on the infection. It is still important to practice safe sex to reduce the risk of transmitting other infections.

To minimize the risk of passing on HIV to their child, women with an undetectable viral load should not breastfeed.

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