So what does undetectable really mean

[pozguy]

Lots of guys now say they are undetectable, does that mean they are on meds? I have seen a comment somewhere that undetectable can also include full blown, what's everyone's view

[bearbandit]

Undetectable is variable and depends on the lab: some labs say that less than forty copies of the virus counts as undetectable, others fifty, or even seventy. A few years ago it was four or five hundred. The vast majority of undetectable guys will be on meds, but it's possible to be undetectable and not on meds - just very unusual.

We use a different definition of aids in the UK (for example we don't use the "less than 200 CD4 cells" part of the US definition) and most doctors talk in terms of degrees of severity of HIV disease. What America defines as aids tends to be stage C3 HIV disease here, and it's perfectly possible for someone to be at that stage and have an undetectable viral load: my last partner was ill for four years before he died and was undetectable for all but the first couple of months of his illness. In his case the virus had already done the damage and he was ill with MAI; his CD4 count never got above about 125 throughout his illness, but his was a late diagnosis that illustrates the need to test regularly in order to catch the little bastard early, if you test positive.

[Bottom Jim]

I have been told that undectable means a viral count below 50. Remember that does not mean he is not positive . He is just a very low count and 99% of time on meds

[GermanFucker]

Undetectable is variable and depends on the lab: some labs say that less than forty copies of the virus counts as undetectable, others fifty, or even seventy. A few years ago it was four or five hundred. The vast majority of undetectable guys will be on meds, but it's possible to be undetectable and not on meds - just very unusual.

We use a different definition of aids in the UK (for example we don't use the "less than 200 CD4 cells" part of the US definition) and most doctors talk in terms of degrees of severity of HIV disease. What America defines as aids tends to be stage C3 HIV disease here, and it's perfectly possible for someone to be at that stage and have an undetectable viral load: my last partner was ill for four years before he died and was undetectable for all but the first couple of months of his illness. In his case the virus had already done the damage and he was ill with MAI; his CD4 count never got above about 125 throughout his illness, but his was a late diagnosis that illustrates the need to test regularly in order to catch the little bastard early, if you test positive.

Fantastic post, BB, couldn't agree more.

It is very, very rare for someone to be undetectable without meds, even long-term nonprogressors usually have a measurable, albeit relatively low viral load. But such cases of "elite controllers" do exist (fact). But not everyone who claims to be one actually is.

I've seen the problem with late diagnoses in a friend of a friend, although his viral load went undetectable quickly, he still has been fighting Karposi's for quite some time now, because of the damage the virus did to his body and because his immune system hasn't yet recovered quickly enough. Many guys, especially if they're young, make a quick recovery once on meds, with the increasing T-cell count reversing / pushing back the effects of the disease.

[TigerMilner]

My doctor says that undetectable is now considered below 20. The changes in the number are due to increasingly better and better testing. Undetectable refers only to the measure of hiv virus in the bloodstream. It has nothing to do with CD4 cells or AIDS diagnosis. It is achievable within 30 days of going on meds, but as has been pointed out, that doesn't erase whatever damage the virus may have already done. That is why it is so important to get tested regularly and get on meds as soon as possible, before the virus invades your dna and does damage you may never recover from.

[pozguy]

Thanks guys, 12 months poz, so was just wondering at what point I might be deemed undetectable, as am in UK sounds like will be following bearbandit's definition

[BearOKC69_Poz]

PozGuy: Individual results will vary and it depends on what combination of drugs are found to be effective for you...I was lucky, when diagnosed my viral load was over 2 million, the first drug combo worked and I think I was undetectable within 3 months and with every test my numbers keep getting better (3 years Poz now)

[sthrnguy]

I tested poz on June 3, was at an ID doc on June 6 for my first viral load and CD 4 count. I was still going thru seroconversion (fuck flu) at the time, although it was the tail end but my numbers were BAD. I had a VL of over 10 mil and a CD 4 count well below 200. I was put on an antibiotic immediately to prevent pneumonia. My last VL and CD4 before going on Atripla was on 6/20 anf my VL was down to 23,000 but the CD4 count had declined even more. On June 25, a month after first feeling ill I was on meds. They worked... By the end of August I was undetectable and the CD4 count was back up to 401. MY partner has been poz for 14 years and has been on meds for 5 completely undetectable.

[bearbandit]

Viral load always goes crazy during fuck flu, but settles down afterwards. I had fuck flu in 1980 and despite the crappy medications of the nineties I kept on going. I think the highest viral load I've ever had was 65k - I think they worked out the VL test in about the mid nineties. If you can tolerate the efavirenz in Atripla (and if you can't there are alternatives - demand them!) it's bloody good at pushing the VL down as you've discovered. Over the past ten years I think I've only slipped into detectable - even with the moving goalposts - maybe four times.

[TigerMilner]

Your next blood work will again measure your VL and you will be deemed undetectable when it is undetectable. Meaning the test can't measure below 20, 25, 50 or whatever range of tolerance your specific test uses as it's parameters. Undetectable is the result of the test when meds are working. At least as far as viral load goes.

Thanks guys, 12 months poz, so was just wondering at what point I might be deemed undetectable, as am in UK sounds like will be following bearbandit's definition

[bearbandit]

Information I got from THT's Health Trainer yesterday which was news to me...

About 10% of guys who show up as undetectable by blood test have detectable levels (albeit low) of HIV in their semen. Of course, testing cum for viral load isn't routine (can you imagine the queue the the post of volunteer fluffer? ) However, integrase inhibitors such as raltegravir and dolutegravir seem to have the potential of suppressing resting infected CD4 cells, thereby lowering the risk of having a detectable viral load in cum.

It's becoming evident that raltegravir, which is currently a twice a day pill may become a once a day pill, provided that it's taken with food (which slows its absorption). I must point out that this idea is not yet tested, so if you're on raltegravir (which is very gentle on the system, I've found, but hard on HIV), keep to the twice a day dosing until advised otherwise by your doctor.