Question
What is my risk of viral load rebounding?
10 August 2011. Related: All topics, CD4 and viral load, Living with HIV long-term.
In December 2010 my VL was less than 48 and my Tcell was 984. In August 2011 my VL is less than 20 and my Tcell is 799.
My concern is that i’m getting worse and my worse fear is i’ll become detectable. What is the chances of this happening even if I continue to my daily regiment and do the best I can to stay healthy?
Answer
Your results are all really good and you have nothing to worry about.
A doctor wouldn’t see your CD4 results as significant and your next count could easily be higher again. CD4 counts can fluctuate from day to day without it meaning your health has changed. Any CD4 count about 500 is considered ‘normal’ and you are well above this.
The viral load results mean that you will not develop resistance – so long as you are good at not missing your meds – and you can rely on them keeping you well for years. After viral load has been undetectable for six months or so, and especially after a year or longer, the risk of viral load rebounding, based on results from the UK, is less than 5% a year. These cases will nearly all be related to adherence.
So the direct answer to your question is likely to be less than 5% a year, but that this may be closer to zero if you are good with adherence.
When blips or low-level viral load rebound occur in someone with stable undetectable viral load and perfect adherence, it is nearly always a lab error.
Here is more info about CD4 results.
Here is more info about viral load results.
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