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50 copies/ml are no longer considered an undetectable viral load. Why?
Jun 13, 2011

Hello Dr. Bob, I was rather surprised today when I met with my doc to go over my lab work. He informed me that my viral load was no longer undetectable. Naturally I freaked out!! :-/ Because I work out regularly, eat healthy, and I take my ATRIPLA faithfully and have never missed a dose since I started treatment 2yrs ago shortly after being diagnosed. Well, after my brief mental break down he explained that 50 copies/ml are no longer considered an undetectable viral load and that it has been changed to 20 copies/ml. is this something in Connecticut or everywhere? He told me I shouldn't be worried because my viral load was 22 copies/ml. But my fear is because I was slightly above 20 copies/ml; does this mean I might be building up a resistance to my medication?

Thank you for your time! :-D Sincerely, worried yet slightly dramatic guy lol

Response from Dr. Frascino

Hello, Worried Yet Slightly Dramatic Guy,

HIV tests for diagnosis as well as for monitoring have been improving over the years. The initial HIV viral load tests could only measure down to a count of 10,000! So anyone below 10,000 was "undetectable"! Undetectable means not able to be detected using the lowest limits of the particular testing assay. We all have small amounts of replicating HIV in our systems at all times. Research tests can measure down to levels even lower than ultrasensitive assays now commercially available that measure down to 20 or 25 copies per ml. Should you worry about a viral load of 22? No, absolutely not. If you begin to see a trend upwards over subsequent viral load determinations (such as 22, 50, 500, etc.), a resistance test may be considered to ascertain if you've developed resistance to any of the three components in your Atripla. It's also important to note that "blips" are not indicative drug resistance. See link below for more information regarding viral "blips."

By the way, you're way less dramatic than most of the guys writing into this forum! Some really seem to be trying to get an academy award nomination.

Be well. Don't worry, OK?

Dr. Bob

First blip! - Should I worry. (BLIPS, 2010) May 7, 2010

Hiv-1/2 EIA RR, Hiv-1 WB Negative
I really need to know.

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