Undetectable vs Zero viral load - the new blood test

[Deaner]

This is bizarre. I just got back from the doctor, and she informed me that they now have a new test.

My viral load is no longer undetectable, it is officially ZERO. Of course, I'm still hiv+ and need to stay on meds to keep things that way.

But when did this new test come out and why did I not hear about it? Anybody else have experience with it?

And more importantly, what are the ramifications? Does this mean that I could honestly say that my chances of transmitting to another person have gone from 1-in-a-million to zero? Are people who previously considered themselves undetectable now tempted to say they are negative?

Coincidentally, my CD-4 count has also tripled in the past 6 months from 300ish to nearly a thousand, even though I've been on Atripla for years without change (and the doc assures me this is simply fortunate, it's not like I'm suddenly cured or anything)

[NiceHard1]

My understanding is that the tests have always returned an actual number of HIV copies per ml blood, however when the results were under 50 copies, it was not as reliable, nor important exactly what that number was. So under 50 copies was always returned as "undetectable".

I have not heard of this new change. I think it is interesting to hear, though I'm not sure how significant or accurate that difference is.

[Deaner]

And a quick google search pulls up no information on the subject, other than a bunch of quotes from doctors saying that "undetectable does not mean zero and you are still slightly less dangerous than a plague-infested rat".

When my doc told me about this, I was astounded and asked her repeatedly what it meant (though I didn't think to ask about transmission). She said that the office was similarly unsure when Quest (the lab diagnostics company) started sending back results with 0 instead of the usual <40. Their response was that the new test is now accurate enough to actually test down to the level of 0 or 1, instead of the old method which simply relegated anybody under 40 as 'undetectable'. While I still have hiv antibodies, and there may be dormantly infected blood cells, there is no active virus in my blood. If I were to go off meds, my system would still be able to allow the virus to reproduce from the dormant virus already inside my blood cells.

Isn't this the kind of information or technology breakthrough that should have spread like wildfire through the medical community?

[Deaner]

BTW, my doc office where I got this info is the HIV/AIDS department at the County Board of Health. We're in suburban Atlanta, only about 20 miles from the CDC. It's not like I spoke to a backwater vet who has little to no understanding of HIV.

[HungLatinDom]

If confirmed, this is amazing.

I am going to ask my friend who is a specialist in the subject and see if he has heard something

[GermanFucker]

So basically it's a better, more acurate test for blood samples. Which is a really good thing. More precise knowledge never hurts.

But I think the old caveats still apply: Viral load in other body tissues and fluids (e.g. semen) might differ or lag slightly compared to blood. Also current meds can not really reach the virus in the resting parts of the immune system, so there always is a reservoir (i.e. If you go off meds, HIV will come back with a vengance). Other infections like syphillis, HepC etc. can also still lead to a transient spike in viral load.

What I would take away from this: You seem to be taking good care of yourself and the therapy is working great. Your risk of infecting others is there, but it's minute, i.e. the risk is largely theoretical. It could happen. But so can condom breakage oder nuclear terrorism.

[Guest Matias47]

I started the new more sensitive test last year. It doesn't go to zero, the new level is 20ml instead of 50. I double checked with my doc when I saw this thread. He's never heard of a test that goes to zero. I then contacted a buddy who works at the lab which does the testing -- he confirmed the newer test goes to 20. I suggest we all triple check.

I'm in L.A. if that makes a difference.

[barecumhole]

Well, there are existing microbiological tests that can detect the presence of arbitrary sequences of DNA/RNA in a sample even if there is only one copy present, as well as tests that can detect HIV in your blood without the long delay of the antibody tests (i.e. PCR), but they are ridiculously expensive and impractical for regular screening.

[copenhagendipper]

The "new" test isn't really new. It is just more sensitive as someone else has stated. The fact that only <20 copies / volume of blood is really just a calculation of the sample taken at that time. You'd have to have a cutoff somewhere and that is slightly lower than then <50 copeis/volume before, thus is more sensitive. Slight fluctuations would be expected. Wide swings indicates a medication regemine problem.