Question
A 50000 viral load blip…
13 April 2023. Related: Adherence, All topics, CD4 and viral load.
My latest blood test comes out like this
4/8/21 – cd4 373. 11.42% ND
23/2/22 – CD4 346 12% ND
1/3/23 – cd4 215 15.29%. VL 58049
My doctor insists I stick with my regular meds. I know sometimes a blip might happen. But 58k blip doesn’t look normal. I’m worried I might have developed some kind of drug resistance already.
What should I do now? I’m so lost.
Answer
Hi, how are you doing?
You are right. A viral load blip up to 50000 is not normal.
Your CD4% is still continuing to rise. This suggests your treatment is working. Though your actual CD4 count has fallen. Have you had a recent infection/vaccine? These can cause false results. The Cd4 count is a less accurate result because it most susceptible to being altered by other this whereas the CD4% is more stable.
Have you been offered a second test to confirm your results? The most likely explanation is that there has been a lab error.
What treatment are you on? and have you been taking it daily? I understand that resistance is a worry but resistance to treatment is rare, especially if you regularly take your medication. Have you had a switch in medication between these tests?
Josh.
Hi Jack, good to hear that you have an ultrasound/hep B=C testing booked. I know saying not to stress is easier said than done but before having confirmed results, it is still better to recognise that the most probable cause of the elevated viral load was a lab error rather than something that you have done.
Hi Josh,
Yea I’ll be doing liver ultrasound next week and hep b/c testing on July.
It’s really stressing me out to think about the viral load. Makes me question myself what did I do wrong even knowing it could be lab error =(
It is good that your doctor has suggested to return in 3 months for a second viral load test. This will be enough time for any changes to settle if something else had been the cause of this rise. Is your doctor looking to investigate for any causes that has lead to an increase in your liver results?
Add on – the doctor did told me to come back 3 months later for viral load test again and stick with my current meds. I never switch my medication between the tests too.
Also, my liver AST/ALT reading is 68/86 so my doctor is more concerned with this matter now.
Hi Jack, being late by 10-20 minutes is not going to risk resistance. As you are taking it every day it suggests this is more likely a lab error. Are you able to access a second test to confirm these results?
While your CD4 count is still low you are more vulnerable to fungal infections. Did the oral anti-fungal you were given help clear the infection?
Hi Josh. Thanks for answering my question.
Currently I’m still on atripla. And I’m taking it every night. Though Im late sometimes 10-20 minutes, but I didn’t miss a dose.
I had skin fungal issue during Feb and dermatologist prescribed oral antifungal for me.