Question
I missed my meds for 4 days, will I be OK?
7 May 2019. Related: All topics, CD4 and viral load.
I’m traveling for work and forgot my meds…Meaning I will miss 4 doses of Biktarvy
My viral load has been undetectable for nearly 10 years now and I am otherwise in very good health… so how dangerous is missing 4 doses?
Answer
Thanks for getting in touch.
Meds needs to be taken every day to make sure that there are always good drug levels in your body, Getting the timing right means you still have good levels when you come to taje the next dose. This is for week day and weekends, every day in the year.
Luckily though, as drugs have become better, they also provide cover if you are sometimes late.
Though missing four days is not good, you should be okay. This is because after ten years, levels of HIV will be very very low. If you do this often though, you might develop drug resistance.
Your partners will also be okay from this time. It usually takes a couple of weeks for a viral load to rebound. As soon as you get home, make sure that you take your meds. If possible you may want to have your viral load checked.
Hi Issac, for any further information about transmission please see here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Thank you for the fast response. It’s been bothering me for a while. One more question, what the odds if we did unprotected sex with rectal bleeding involved? Hope you got a blessed day ahead of you, sir
Hi Issac, as you had been undetectable previous to this there will be no risk to your partner/no risk of resistance.
From being undetectable, it can take a week or more for your viral load to rebound and become detectable again. As you had missed only 4 days of treatment (which isn’t advised to do often) this is not a long enough amount of time to risk your viral load increasing.
You will have not lost your undetectable status and there is no risk to your partner or of resistance.
Hi thanks for the insightful information you had been sharing with us. I want to ask you something. In my case, I’ve been took the drugs for the past 3 years, and in July 2023, when I did my first viral load, the result was undetectable. Unfortunately, on October 2023 I missed a consequetives four days of drugs, and I did unprotective sex with my partner a couple days later. My question is,
1. Does my partner are at risk of HIV transmition?
2. Will my viral load rebounded if I missed four days of drugs, even though I just recently undetectable?
3. How about drugs restistance if I still took same meds as before?
Thank you.
Hi Jake, no this will not lead to resistance. As you have been on treatment for so long and undetectable, viral rebound would not be seen until after a week without treatment.
It is viral rebound that risks resistance. As you were not away from treatment for a week there is no risk of resistance. Your treatment will still work.
Missing an occasional dose is expected and normal. Only missing 3-4 doses in 10 years in excellent. Your treatment is still going to be effective.
Hi I missed a dose the other day because i was out of town and forgot to bring my medication also i was late for 4 more hours on the next day. will this make me drug resistant?. been taking my meds for ten years now and last viral load last year was undetected. in the ten years i missed a dose around 3-4 times. just really worried because i really try my very best not to miss a dose
Hi Jack, has your nephew restarted her treatment?
As she had been undetectable for 10 years, viral load rebound would be expected after a week without treatment. It is not likely that this had risen too high and treatment is most likely to suppress the viral load quickly again. However as she had been off treatment for 2 weeks she cannot rely on U=U.
It would be recommended to have a viral load test within a few weeks of restarting. This can confirm that treatment is still working and that there is no risk of transmission.
In the meantime she can have sex with her partner by either using a condom, or her partner using PrEP. Both of these methods will prevent any risk of transmission.
Hi,
My nephew missed her ARV treatment for 2 weeks after tested undetectable for 10 years now.
What is the chances of VL to rebound and how long must he weight before having sex with the partner?
HI Gerry, congratulations on having a baby. No this will not risk baby being infected. As you have been on treatment for so long, missing 2 days of treatment is not going to risk your viral load increasing. It is still safe to continue breastfeeding.
Hi.. I am breastfeeding and I skipped my doses 2 days after 1 year will my baby be infected