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 Babes,
What ART are you taking now? And have you just started these second line meds?
Taking meds everyday at around the same time can be difficult for many people. Forgetting to take the meds too often can mean that viral load rebounds.
But now you’re on second line it could be that working out how to take them on time everyday could get you to undetectable. Here’s a link to tips on adherence. This can help you work out what’s best for you and what fits into your schedule.
I’m on ART line 2 ,my last viral load was 1000 must I worry about that ,and which nutrients food I can take to make my viral to decrease,sometimes iay forget to take the meds or ill take it later does that can cause my viral load to be high?
Hi Thabiso.
Please see Q7 here: http://i-base.info/qa/what-are-the-most-asked-questions
does a person who have undetectable viral load and have high CD4 count can also be advice to stop using med (ART)????
Hi Jane.
If its just now and then, you should be OK. Also taking your meds a few hours of your normal time won’t be an issue.
I know that having a baby can be really hectic, but its important that you continue to look after yourself.
I just had a baby and things bave been so hectic that i missed a couple pills here and there….i’ve been undetectable for about 8 months …only been diagnosed just a little over a year now. I have a blood test coming up soon. I been trying to get my adherance back on track. I take my meds everyday but some days im just a little late. How likely is it that i’m no longer undetectable
Hi Ryan, Thanks for your detailed comment. It was a bit long so I’ve taken the main point from it. However, just as HIV can be transmitted once, it can be transmitted again. How often this occurs and under what circumstances make this more likely is not clearly known. You can read more on this question here.
I have been suppressed virally and undetectable since two weeks after starting ART. (VL was 6780 at diagnosis. CD4 429 but today 850). I’m married, my wife is HIV negative and we don’t have sex with condoms. But just because someone is on ART and undetectable, you can still be exposed to a treatment resistant strain of HIV.
Hi Mpho,
Its important that she has her viral load retested, if its still detectable then its possible that your wife is/has developed resistance to her current regime of treatment. Though this may sound scary, there will be other options available. Your wife should speak to her HIV consultant and not the sisters, especially if they aren’t being supportive.
For more info about viral rebounds please see here:
http://i-base.info/guides/changing
Hi,
My wife has been on ARV treatment for over 5 years. She has religiously been taking her treatment every evening at 19:30. A month ago the clinic did blood tests as a routine. Today she went for the results and we are shocked to learn that her viral load is 1000.
How is this possible?
Sisters at the Clinic claim that that she is not taking her treatment.
We as the family we are very supportive to her. We all know when she should have her treatment.
Please advise.