Question
Can partying explain my viral load increase?
12 November 2010. Related: All topics, CD4 and viral load, Changing treatment, Resistance.
Hi
I have been on medications for about 2 years. I am on atazanavir, ritonavir and truvada. I have been undetectable for about 1.8 years and my CD4 is 900, but a blood test taken last week returned a viral load 3,560.
I have been called by my clinic this morning to come in for a new blood test which i did this afternoon. I had the impression that the nurse were worried and I am terrified now. I will have to wait another week to see if I ll be fine. They said that such a result can’t be a blip.
How can a result of viral load 3,560 return to undetectable within 7 days?
Do you think that because I have been partying and took some recreational drugs few days before my blood test, it could have affected my viral load?
Answer
Hi
Thanks for your question and the chance ot post the answer online.
For your personal situation, first get the test confirmed. Laboratory errors, including wrong labeling or mixed samples can explain unexpected results. So the confirmed test will check this is your sample.
Blips are defined differently. They are usually defined as increasing from less than 50 copies to over 200-300 copies/mL. However, I have heard of blips over 2,000 copies/mL that were undetectable on the next test.
Recreational drug use should not have any direct influence on viral load, unless it affected your adherence, and you were late with or missed some of your meds. If you were adherent, and none of the reasons listed below are related, then the partying itself would not be an explanation.
As long as adherence is good, it is very rare for someone whose viral load has been undetectable for over a year to have rebound in viral. In the UK this is less than 5% of people each year.
Reasons for this include:
- Missing or being late with medication. Strict adherence is always important.
- Drug interactions with other medications. Does your doctor or HIV pharmacist know about all the drugs and medications you use?
- Poor drug absorption. Do you have other health problems. for example, diarrhoea.
- Other infections. Infections that activates the immune system, sometimes causes HIV viral load to increase – for example, flu, vaccinations, or some other sexually transmitted infections.
If the viral load is confirmed at a similar or higher level, your doctor will probably discuss the options for changing treatment. You should also have a resistance test whenever viral load is confirmed over 500-1000 copies/mL when on treatment to inform this choice.
Hi Kim,
It’s great that you’ve been taking your medication as per the instructions. And I’m sorry that you feel discouraged. But it’s important to talk to your doctor about why your medication has not managed to get viral load to undetectable.
You can ask to switch to other medication that will work better than this combination. You can also ask for a resistance test to help you switch to treatment that is more effective for you.
hi
i have been on HIV meds for 4yrs now taking rilpivirine and a combination of tenofovir/fumarate/emtricitabine last year 2019 December i did the test and my viral load was 488 and again in april i repeated the test viral load increased to 888. i have been taking my medication as per the instructions given by the doctor now i’m worried what could be the cause for the increase to my viral load. i never had any infections before my second tests.
i feel so discouraged about the results i keep getting i have never managed to get my viral load undetected.
please help with ideas to keep my health in good condition
Hi Amit,
This could be a lab error, however it could also be an issue with your medication. Having another viral load test will be able to confirm if it was a lab error or if you’ve developed resistance. SO it’s good that you’ve had another viral load test done. When do you get the results?
I am on ART from last 2 years and VL was undetectable . I take VL test evey 3 months and every time it was undetectable but this week result came as 18900.
Which is surprising as i am taking my meds regularly without fail.
I have gone for re test and result is awaited.
What can cause this sudden jump in VL when on Medication?
I am worried now.
Hi Swirl,
If your viral load has increased this would imply that the medication that you’ve been taking is no longer working like it should do. This is something that you’ll need to discuss with your doctor. And change to another combination. Please see here: http://i-base.info/guides/changing
If the increase in viral load has been slight, then this could be due to an error or even at a push stress. However 28,000 is a big jump.
Hello
I am Swirl my viral load has drastically increased to 28000ml/copies mean while my CD4 has increased from 171c/ml to 232.4c/ml.I am on Tenofovir Disoproxil and Nevirapine tablets and have been on it since January 2018 what can cause my viral load to be that high? Please help me I also have a very stressful job which I just abandon. Thanks
Hi Eric,
What meds are you taking as part of ART? Has your viral load been below 477 at all?
After 3 years on ART you should expect your viral load to be below 50 and undetectable.
What does your doctor say about these results? And was your September test 12,200 or 1,220?
Are you able to keep up taking the meds all the time? If you’re fine with adherence then it’s important to see your doctor as you may need to change treatment.
But as these results are unusual it’s a good idea to talk to the doctor about them soon.
Hie
I have been on Art for the past 3 years. In April 2018, my CD4 was 500 and viral load 477. However, when I conducted another test in September my viral load read 12200 cplm. What suddenly caused the change?