Frequency of viral load testing

A baseline viral load test should be done twice if possible. If not on antiretroviral therapy, viral load testing is usually repeated every three to four months.

If antiretroviral therapy is started, the viral load should be repeated within one month, then between three to four months, and again at four to six months. A fall in viral load to less than 1000 copies/ml within one month generally indicates that at six months, response will be sustained.

If viral load indicates treatment failure, the test should be repeated. Occasionally, there are viral blips and, at low levels, these are generally not indicative of resistance or treatment failure.

In some cases, combinations can reduce plasma viral load to below the limits of detection, even among people who have low CD4 counts or who have taken anti-HIV drugs before. If viral load is 'undetectable', HIV may be less likely to develop resistance to the drugs. However, the drugs may not have such a powerful effect throughout the body and the effect may not last. The question of whether people with 'undetectable' viral load are infectious to others is currently a matter of intense discussion.

As with CD4 counts and other laboratory tests, what matters most in interpretation is the trend over time, rather than any single test result. The same viral load test used on the same sample of blood can produce a different result because of the degree of variability in the test. Various factors can cause a temporary blip in the viral load, especially events that stimulate the immune system, such as flu, colds, and vaccinations.

People who develop an opportunistic infection tend to experience a temporary increase in viral load of around one log. The viral load usually returns to its previous level within a few months of successful treatment of the infection.

Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.