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Are We Still Just Guessing?
May 29, 2005

Good morning Doctors,

Thanks for this great resource. I posted this same letter, but to the wrong forum. I hope the two don't cancel each other out.

I am now at 2 1/2 years off meds. I have been part of a study group since my seroconversion just over 5 years ago. This is my third and longest supervised interruption. The previous two only lasted 10 weeks each.

I have a question about the V/L tests currently being used (are they the PCR and the NASBA?). How can they both be legitimate if they can render different results from the same patient and the same blood draw? Quite accidentally the wrong test was used for my last blood draw and bore a V/L count of 29,000. When they discovered they used the wrong test, they ran the alternate test with the same blood which bore a V/L count of 9,000. This result was presented to me with a Youll be happy to hear that. Can you help me understand this disparity? Its hard to be happy to hear, or give more weight to the second result than the first, knowing that both are legitimate? Logic shouts that if the tests are both correct, then they are also both incorrect. This leaves me, the patient, without a point of reference. It also makes me wonder if any of these numbers really mean anything.

For the last 6 months I have been eating poorly, exercising less and smoking more. In short, my temple is a mess. Yet, according to the results of the correct test, my Ts climbed and my V/L dropped by 20K. This makes no sense to me. The results of the wrong test make more sense in the cause & effect world.

Can you help me to understand how I can use these numbers to manage my HIV infection? Or, can you direct me to a site that can? Isnt there a HIV for Dummies out yet? Or are these numbers meaningless and are we still just guessing?

Thanks.

Response from Dr. Holodniy

You don't indicate which viral load result is from which assay. However, the assays track each fairly closely. There is only a three fold variation in these numbers and would not be considered a clinically significant difference. If one result was 29,000 and the other result was 900 or 900,000, that would make me pause and say something is wrong here.



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