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Related Experiment Video

Updated: Jun 23, 2026

Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
13:58

Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays

Published on: September 26, 2011

How reliable is an undetectable viral load?

Christophe Combescure1, N Vallier, B Ledergerber

  • 1Division of Clinical Epidemiology, University Hospital Geneva, Geneva, Switzerland. christophe.combescure@hcuge.ch

HIV Medicine
|May 23, 2009
PubMed
Summary

Reliability of undetectable HIV viral load (VL) increases with sustained suppression on highly active antiretroviral therapy (HAART). Patient compliance is key to maintaining low VL and preventing transmission.

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Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
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Area of Science:

  • Virology
  • Immunology
  • Public Health

Background:

  • The Swiss AIDS Commission suggests patients with sustained undetectable HIV viral loads (VL) on highly active antiretroviral therapy (HAART) are not infectious.
  • This raises questions about the reliability of undetectable VL and the factors influencing it.

Purpose of the Study:

  • To assess the reliability of undetectable HIV viral load (VL) in patients on HAART.
  • To identify factors that determine the reliability of sustained viral suppression.

Main Methods:

  • Analysis of viral load data from 6168 patients in the Swiss HIV Cohort Study (2003-2007).
  • Used general estimating equations to determine the probability of VL exceeding 50 or 1000 copies/mL after a previous undetectable VL (<50 copies/mL).

Main Results:

  • Reliability of undetectable VL (<50 copies/mL) reached 94.5% after 5 consecutive measurements.
  • Reliability increased to 99.1% with a higher VL threshold of 1000 copies/mL.
  • Patient compliance, current HAART regimen, and prior ART history were significant predictors of reliability.

Conclusions:

  • Sustained undetectable HIV VL on HAART demonstrates high reliability, approaching 94% at <50 copies/mL and 99% at <1000 copies/mL.
  • Patient adherence to HAART is the most critical factor for maintaining viral suppression and reliability.