Hello Doc and thank you for being there. I've been on Atripla since March '09 and became undetectable around Nov '10. Stayed Undetectable for 6mos. May '10 (vl=Undectable,cd4~421). Now Sept'10 (vl=7400,cd4~408). Is this a clear indication of resistance to Atripla? I have never missed a dose and allways take my doses within 2-3hrs of dosage time. i have good tolerance. I do occasionally eat a snack and do drink alcohol prior to taking meds on weekends, esp during vacations. i have had unprotect. sex wt poz guys. Could this be an recent absorption/alcohol/blip issue or should resistance testing be done immediately? Am afraid of side affects of new meds.

The viral load should be repeated. If that increased viral load is persistent, then a resistance test should be ordered to determine which HIV meds your virus has become resistant to, and what you need to be changed to. To go from undetectable to 7400 would not be considered a blip.