Question
I am scared that my viral load has rebounded over 750…
29 July 2011. Related: Adherence, All topics, CD4 and viral load, Changing treatment.
I recently went in for my latest labs, all great, except viral load was now dectable at 267. So my doctor had me redo the test, I did at another location on a saturday morning. The white blood and T-cell count still stable and good at almost 700.
The viral however went to 751 now so they redid the test again and also a genotype resistance test.
My fear, is that I missed a dose once in a blue moon, out with friends and drinking, and just forgot, and once I took the pill but could not recall if I did , so took another. I was told it would be OK both circumstances. My fear is that Atripla is no longer working and Im not sure why. Sometimes I have eaten before I take it , I know the side effects increase, but does the medine stop working?
I have been undectable a good 3 yrs now but I’m really scared, I work out every day two times a day and I feel great, so I am not sure what is happening. All other labs have been stable/good. When re-doing the test I did at another locale, so doc is thinking the time that the blood was taken and transferred to the testing site, could have replicated in the blood to go up in the viral load.
I’m scared that I wont be able to find another medicine that will be OK for me and my appearance as well my body.
Please get back to me, thank you! T-cells were 583 at the latest labs, this last time were 696 My CD% 21 to 22% Doc said all is stable . Please advise….Confused, and scared.
Answer
It is extremely rare for someone who has been undetectable for many years and who has been taking their meds to have a viral load rebound. There is no mechanism for this to happen. This is because while undetectable (less than 50 copies/mL) the virus does not evolve and therefore does not develop resistance.
This makes it much more likely that this is either a lab error or a blip much more likely. Although most references to blips have a cut off or around 200, I have heard of people who get a freak result up to 2000 and their next test result in back undetectable again. It is rare but possible.
None of the other thing you mention – an odd missed dose, or food or drink would affect this.
The other explanation for genuine rebounds – and you will know this if the confirmed test is also this level or higher – is when people are reinfected with a different strain of HIV that is resistant to the drugs they are currently taking.
This is a caution against barebacking with partners who have detectable viral load and drug resistance.
If this isn’t possible because you haven’t been at this risk, then this is most likely a lab error. If it is confirmed by the resistance test that the meds have failed – it is good that your doc did this –Â then there are many other combinations you can use.
These combinations will be just as good for your appearance and body. If this turns out to be the case and you want info on the options and choices, please let me know and we can go through this.
Or let me know anyway, especially if the next results turn out ok :)
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