Question
What does a low but detectable viral load mean?
22 August 2012. Related: All topics, CD4 and viral load, Resistance.
Way back in April 2011, I started HIV treatment.
At that time my CD4 count was 250 and my viral load was 29, 000. My ID doctor prescribed Combivir (AZT/3TC) and Sustiva (efavirenz).
In December my lab results were CD4 423 and my VL was undetectable.
Further results were carried out in March and in July 2012 however these results got me worried.
My lab results for March indicated that my CD4 dropped from 423 to 380 and my viral load has increased from less than 20 to 87.
On enquiring with my ID doctor he informed me that such a increase in the viral load could probably be a blip and he wanted to see the trend of another 2 lab results.
Today I have called for my results and found out that the viral load for the test carried out in July 2012 increased once again from 87 to 123 – CD4 count not yet established.
Even though they’re saying that such an increase is of insignificant value, I am still being very concerned about these results. Could it be that the treatment is failing?
Looking forward for your answers, please.
Answer
Hello,
Thank-you for your email.
The British HIV Association treatment guidelines define virological failure (treatment failure) as two consecutive viral load results of more than 400 after a previously undetectable viral load. This is the point at which treatment change is indicated.
Low levels of detectable virus (where the viral load is more than 50 and less than 400) occurs in up to 8% of people on treatment. Often this can be reversed through improved adherence or alteration of doses. Generally this is not considered treatment failure and not a reason to recommend changing treatment.
If your viral load is rebounding due to resistance you would expect to see a significant rise in your next viral load test. If your viral load remains at this low but detectable level your doctor may want to measure drug absorption levels, or talk about adherence.
Hi Debra, it is not possible to know how many exact copies there are. LDL means low levels detectable. This means the test can detect that viral load is present, but the test is not sensitive enough to know the exact amount.
I just want to know how many copies are there in LDL