Question
What do my test results mean and do I have resistance?
3 June 2011. Related: Adherence, All topics, CD4 and viral load, Changing treatment, Resistance.
Hi
I changed hospitals a year ago and am now trying my hardest to understand my results the best I can. I find that when I have had to chase them up on the telephone, the clinic adviser tends to skate over my results. It is only when I see my consultant for my next bloodwork appointment, that I recieve a more in depth summary of my results.
My CD4 count has gone down from the 501 to 220. How can I tell if I’m developing resistance against my medication? The health adviser at my clinic asked me if I am taking my medication as perscribed (which I am apart from the rare blip).
I am concerned that I have developed resistance to my medication and it won’t have been obvious to the health adviser.
Could you please explain to me what exactly indicates resistance – what to look for when I get my blood results back?
Thank you for the excellent advice and support network you provide to us all. It is invaluable.
Answer
Thank you for your question.
You need to ask your health advisor or your doctor for your viral load test results. A viral load test is the most sensitive test to check whether a combination is still working or not. If your viral load is undetectable then it is possible you are just experiencing a CD4 count fluctuation which is very common. For more information on CD4 count fluctuations please follow this link to a similar question.
If your viral load has rebounded and become detectable again (usually over 2000 indicates treatment failure rather than a blip) then you need to firstly ask for a repeat test straight away to see if the result is accurate. Secondly you need to ask for a resistance test. This will tell you which, if any, of the HIV drugs you have resistance to and the severity of the resistance e.g. whether there is any cross resistance to other HIV drugs.
Having resistance is nothing to worry about, it just means you need to change your medications slightly to find a combination that works to make your viral load undetectable again.
For more information on viral load tests and how they can indicate resistance please follow this link.
To read our guidebook on resistance and changing treatment please follow this link.
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