Question
Could health problems mean my viral load has rebounded?
12 November 2021. Related: All topics, CD4 and viral load, Complications and coinfections, Opportunistic infections.
I am 34 year old man. I tested HIV positive in December 2019 and started ART. My combination was dolutegravir, tenofovir alafenamide and emtricitabine. My initial CD4 count was 171. After one month, viral load was undetectable.
In December 2020 my CD4 Count was 304 & VL undetectable.
In the first week of October 2021, I had fever and running nose. Then in November 2021 I was admitted to hospital with severe bloating and fever. The doctor said it may be gastritis, and started to take medication. I am feeling well.
My CD4 count is now 258. Is it possible that my viral load rebounded?
I was taking ART medication regularly. All my other tests came normal (liver function, kidney function and routine blood tests) except two – neutrophils in blood (54.8%) (Range 60%-80%),and C-Reactive Protein 6.75 mg/L (Range 0.0 mg/L to 1.00 mg/L).
They are waiting for my viral load test results.
Answer
Hi there
Thanks for all these details which are really helpful when answering your questions.
It sounds like the recent hospitalisation with stomach problems is now okay and are not causing you problems. This part of your health needs to be managed by your doctor.
It also looks like your HIV meds (ART) are still working well. If you have been good at not missing doses, then there is no reason to think your viral load will have rebounded. Again, your doctor has done the right thing to order a new viral load test.
Getting this result is now the most important thing. If is is still undetectable then your HIV meds are still working well. IT also makes it unlikely that your stomach problems were related to HIV.
You have a good CD4 count and it doesn’t matter if the recent result is a little lower than the one before. CD4 counts can vary between tests without meaning there is a real change.
Please ask your doctor about the neutrophils and CRP results. These can also vary, including being outside the recommended range.
The neutrophil result is only just outside the normal range so is probably fine. CRP is a marker of inflammation and might have been related to the hospitalisation. Both CRP and hs-CRP can be used and results can be mg/dL or mg/L. Without the details of your test, it is better that the doctor explains this, as you might still be in the normal range.
Your doctor needs to expalin whether or not these need further tests.
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