Suppressing viral load

Suppression of viral load, also known as HIV RNA, indicates that the virus is no longer replicating and infecting new cells. Viral load suppression has been shown to improve the health of people with HIV/AIDS-related illnesses and to reduce the risk of death due to AIDS.

The goal of antiretroviral therapy is to suppress HIV viral load to an undetectable level (usually defined as less than 50 copies/ml) within four to six months of starting antiretroviral therapy.1

The evidence for a link between low viral load and a good prognosis among untreated people, and between viral load reduction and an improved prognosis in those receiving treatment, is discussed in the section Monitoring the immune system.

For people who have never taken anti-HIV drugs before, there is now a very good chance of suppressing HIV below 50 copies/ml with their first regimen.1 2 In treatment-experienced patients with a sustained viral rebound, causes – including poor adherence, drug intolerance, drug interactions, and incorrect dosing – should be explored. Switching to a regimen that includes three active agents (perhaps utilising one or more of the newly licensed drugs etravirine, maraviroc, or raltegravir) should be effective even in multidrug-experienced patients.3 4 5 6 7 


  1. Gazzard BG, BHIVA Treatment Guidelines Writing Group British HIV Association Guidelines for the treatment of HIV-1-infected adults with antiretroviral therapy 2008. HIV Med 9(8): 563-608. Available online at, 2008
  2. Panel on Antiretroviral Guidelines for Adults and Adolescents Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. November 3, 2008; pp 1-139. Available online at [Accessed 30 Oct 2009], 2008
  3. Fätkenheuer G; MOTIVATE1 and MOTIVATE 2 Study Teams. Subgroup analyses of maraviroc in previously treated R5 HIV-1 infection. N Engl J Med 359(14):1442-1455, 2008
  4. Gulick RM et al. Maraviroc for previously treated patients with R5 HIV-1 infection. N Engl J Med 359(14): 1429-1449, 2008
  5. Clotet B et al. Efficacy and safety of darunavir-ritonavir at week 48 in treatment-experienced patients with HIV-1 infection in POWER 1 and 2: a pooled subgroup analysis of data from two randomised trials. The Lancet 369: 1169-1178, 2007
  6. Haubrich R et al. Combined darunavir (DRV) and etravirine (TMC125; ETR) resistance analysis of the pooled DUET trials: when can we spare the other new classes? XVII International AIDS Conference, Mexico City, Abstract TUPE0048, 2008
  7. Steigbigel RT et al. Raltegravir with optimized background therapy for resistant HIV-1 infection. N Engl J Med359(4): 339-54, 2008
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.