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When viral load becomes undetectable

Jun 15, 2014

Hi Dr. Mark,

I apologize if this is a blatantly obvious answer, but what exactly does undetectable mean? I mean, say a person has an initial vl of 100,000 and they start medications - 4 months later they go for a checkup and they have an undetectable viral load. But where exactly does the hiv go? The hiv certainly isn't killed off, but it's now considered undetectable? Can you explain what this undetectable means?

Happy Father's Day

Response from Dr. Holodniy

Undetectable generally means the HIV viral load in blood plasma is below the limit of detection of the assay. It does not mean that HIV has been eradicated from the blood or other organs, as CD4+ and other cells can contain latent virus within them. Measuring viral load in blood is a good proxy for ongoing replication, within blood cells or other organs of the body. When the viral load test is undetectable, usually as a result of HIV treatment, it generally means that although latent HIV still exists within cells, it is not actively replicating.

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