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Undetectable VL and HIV Antibody Test
Jul 6, 2001

Hi, Can I ask a very naiive question. If an HIV positive person has an undetectable viral load, does this necessarily mean that one would test HIV negative? Thanks.

Response from Dr. Aberg

The HIV antibody test is different from the HIV viral load. A screening test called an Elisa is done first and then is confirmed by a type of assay called the Western Blot. The Western Blot can identify the exact HIV viral products with which a patient has formed antibodies against.

The HIV viral load measures the amount of virus one has in their blood. When one takes HIV medicines (antiretroviral therapy), it hopefully reduces the amount of virus detectable in the blood. Remember that just because we cannot detect any virus in the blood, that doesn't mean it is not still there. The lab tests can only detect to a lower limit. Some assays may be <500 or <400 or <50 copies per ml of blood. This does not mean zero. Also, HIV may be found in other parts of the body such as genital secretions, lymph nodes, etc.

So, in summary, a person who is HIV positive and has an undetectable HIV viral load will have a positive HIV antibody test.

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