I have been hiv+ since 1993. At that time I started treatment. My CD4 count has been as low as 250 and now usually arounf 500-600. My viral load always undetected. I go lab work done last week and viral load 1090 and cd4 count 720. What coould be the cause for my viral load to jump. Also I am very healthy except I lost 15 pounds recently and all was fat. I did quit drinking pepsi, but I think it is waisting. also should I really be taking meds with those numbers.

Assuming you have been adherent to your med regimen, a blip like this could be related to the viral load assay (although this is a bit high for that), lab error, another ongoing infection, a recent immunization, or regimen failure leading to resistance. It is very important to have a repeat test sooner rather than later to see whether it's back down or trending up further. If it's the latter, a resistance may be in order. YOu don't indicate what your pretreatment viral load was when your CD4 count was 250. It might not have been available back then. However, your baseline CD4 count does indicate a significant amount of immune system depression prior to treatment. This has some bearing on whether you decide to go off meds for awhile. If you were to stop, you would be in no immediate danger. YOur viral load would rebound to some higher number. Depending on how intact your immune system was, your CD4 count might stay high for a significant period of time, or go down. In any case, it would be important to follow your numbers closely.