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VL is zero
Mar 17, 2008

Hello Doctor Bob

I have your admirer for a while now. I am very grateful for all your advice and help. You are inspirational for us all. Coming to my case, I live in the UK and I have been HIV+ for about ten years now, and am currently on medication taking on Sustiva and Combovir. My CD count is 300 and my Viral load has been undetectable for many years now. However, during the last one year, my test results showed that my viral load becomes zero, which I am happy about. My question is, when it is zero, doesnt mean the virus is disappeared or hidden somewhere. During the last one year, I have taken four tests and all the test results showed the same data, which is zero. Your response is highly appreciated. All the best fb

Response from Dr. Frascino

Hello fb,

"I have your admirer for a while now"???? Hmmm . . . fb, I suggest you let him or her go immediately. Holding my admirers hostage is not a fair way to force me to answer your question!

Regarding your question, an HIV plasma viral load that is undetectable is not "zero!" It merely means the viral load is below the detectable limits of the testing assay. Years ago the viral load test had a testing sensitivity limit of 10,000 copies. That means anyone with less than 10,000 at that time, would have had an undetectable viral load. Current tests measure down to 400 or 50 or in some cases even 25. But these are merely indicators that help us to monitor HIV viral replication. Once someone is HIV infected the virus never leaves them. We can drive viral replication down with potent effective antiretroviral therapy, but the virus is still there in many, many locations. If you were to stop your HIV medications, your viral load would once again skyrocket. You can read more about HIV monitoring tests in the archives and also in the section on "HIV Monitoring Tests Basics" found in the "Just Diagnosed" chapter that can be easily accessed under the Quick Links heading on The Body's homepage.

Be well. (And set that hostage free!)

Dr. Bob


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