How can drugs ‘fail’ and I feel fine?
When the term ‘fail’ is used to describe an increase in your viral load, this should really be referred to as virological failure. It relates to results from blood tests but not how well you feel. It does relate to your risk of becoming ill in the future.
The term clinical failure is used to describe any new or progressing illnesses. This is when you feel unwell. It is often related to virological failure, but may follow several months later.
Your viral load rises first (virological failure), followed by a drop in your CD4 count, which then puts you at greater risk of becoming ill (clinical failure) – see Figure 1 below.
Figure 1: Time from viral load rebound to CD4 changes and clinical symptoms
If your viral load rebounds and you continue on treatment, resistance develops and viral load continues rising higher:
- It may take several months before you see a drop in your CD4 count.
- If you have a strong CD4 count It will take even longer before you have clinical symptoms. If your CD4 count is below 200, then you could experience symptoms more quickly.