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ELISA/EIA & WB result for post-ARV patients with undetectable viral load
Sep 29, 2008

Dear Dr. Bob,

I have been under ARV therapy for 3 years and have been able to keep my viral load in the undetectable range with CD4/CD8 in the 20-25% range. If I were to go under the current HIV antibody tests under ELISAEIA & WB now, would the result still comes out as positive? What happens to the HIV antibodies after the viral load has been contained to undetectable level?

Response from Dr. Frascino

Hi,

This question comes up quite frequently. See below.

Dr. Bob

testing while on ARVs Jan 1, 2008

I am seeking general information related to testing for HIV/AIDS.

I would like to know if a person who is HIV positive and on ARVs will test positive or negative on a HIV test. I am seeking this information because a colleague suggested that someone on ARVs does not test positive on the typical HIV test. Can you please clarify.

Response from Dr. Frascino

Hi,

There are various types of "HIV tests". Antiretrovirals can affect some types of HIV-related tests, but not those recommended for diagnostic purposes. Routine HIV-diagnostic tests are generally HIV-antibody tests, such as ELISA, Western Blot, EIA, immunofluorescent assays, rapid tests, oral swab tests, etc. These tests are all designed to detect anti-HIV antibodies, which are circulating proteins made by the body's immune system in response to HIV infection. These types of tests are not affected by use of antiretroviral medications (HAART, AIDS meds).

Polymerase chain reaction (PCR) assays are used to detect pieces of the virus itself. PCR RNA, for example, is used to monitor HIV plasma viral load. If an HIV-positive person is on effective potent antiretroviral drugs, the medications could drive the HIV viral load to "undetectable" levels. This, however, does not mean the person is no longer HIV infected. It merely means the level of HIV replication is below the level of detection of this particular type of test. An HIV-infected person with an undetectable HIV plasma viral load (PCR RNA) would still test HIV-positive on routine HIV-antibody tests. The HIV-antibody tests are used for diagnosis, while the other types of HIV tests (PCR) are generally used to monitor the course of the illness and/or efficacy of anti-HIV therapy. You can learn more about HIV-diagnostic and monitoring tests by reviewing the information readily available on The Body's homepage under "Quick Links." Check it out!

Hope that helps clarify things for both you and your buddy.

Dr. Bob



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