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 John
Without knowing your full history it is difficult to say what might have caused either the change in weight or the high viral load. It would be helpful to know how high your viral load is, but it sounds like this might be high enough for you to need to change treatment.
It might be that your HIV already had some drug resistance when you first caught HIV. If this was the case, then although you were very good with adherence, only two or the three drugs in Tribuss would have been active.
This pages has more information about why a treatment can fail:
http://i-base.info/guides/changing/why-a-combination-can-fail
It is great that you have made other life changes to help your health and that your adherence is so good. These will both really help if you change to a new combination.
How is your CD4 count? This is used in some countries to decide when to change.
What is your normal weight? Have you spoken to your doctor about your worries?
I was diagnosed with HIV on November 2013 and since the day I was diagnosed I stopped drinking alcohol and I have been taking the Tribuss medication (one pill every night at 20:00 pm). My weight was 61kg and it dropped to 55kg. Today the nurse told me that my viral load is too high. What could be the reason for this?
Hi Calvin,
Thank you for getting back to me.
Unfortunately it sounds very likely that you have developed resistance to your HIV treatment. Are these the only HIV drugs you have been given?
HIV treatment should be made up of at least three drugs. Darunavir/ritonavir acts as one drug, so you should have had two others with this. Using only one drug makes it more likely you will develop resistance, as does only taking your treatment 3-4 times a week. More information about resistance is available in our guide to changing treatment.
It’s important that you see your doctor as soon as possible, preferably within the next few days. It is likely that you will need to start a new HIV treatment regime. While your CD4 count is at this level you are at risk of developing opportunistic infections, such as pneumonia.
Are you being treated in the UK or overseas?
Hi Rebecca
Yes aim on Darunivir and Ritonivir, but because I have small fibre Neuropathy and reactive Arthritus the Ritonivir makes it difficult to titrate the pain relief so to try snd draw a happy medium I am taking my ARV 3-4 weekly it’s been a matter of quality of life etc, I have been on This particular regime since January 2012.
My CD4 % is 5.5 and my Vitamin D is 24
My pain relief mainly consists of opiates which help a lot. Do you have any observations.
Regards
Calvin
Hi Calvin,
Are you on treatment already?
If you are not on treatment yet it is important that you start treatment very soon, within the next week or two.
If you are already on treatment this increase in viral load suggests that you may have developed resistance and will need to change one or more of your ARVs.
What has your doctor said about these results?
My CD4 has increased to 114 from 57 and my viral Load has increased from 59 to 2657 what would be the reason for both results to act negativity.
regards
Calvin
Hi Thummie,
This is very normal. Until you start treatment your viral load will increase and your CD4 will decrease. This is the natural pattern of HIV infection. What have your last couple of CD4 and viral load results been?
Hellow,may you please help me-my viral load increases and CD4 count is deacreasing.I am using condom during sexual intercourse always,i dont drink,smoke i am not on treatment as yet.What could be the cause?
Drinking alcohol should not affect your CD4 count or viral load unless you were forgetting to take your medication as a result of excessive drinking? Small increases in viral load is common and are often called viral load ‘blips’. You should ask your doctor to re-do the viral load test to confirm the increase as it could be that on the second test the viral load has gone back down again. For more information about viral load blips please follow this link.
i was pregnant recently and gave birth to a healthy baby boy and happy about that. i have taken tripple therapy medication, i gave birth on 25 August 2010 and my viral load have increased and my cd4 also increased, they have changed my pills as i was still taking the tripple therapy medication should be this the cause of my viral load increasing for i was still on tripple therapy for the past 5 months but now they have changed my medication i know take pills at night which is so great….
would like to know what caused viral load to increase as i was drinking alcohol so badly recently but now i have stoped. and am loosing to much weight since i gave birth could this be stress related as me and the father of my child we are no longer together and i think about him all the time..