After 21 years of having an undetectable viral load and a very high Tcell count of 1400 and over, my last test showed I had a 400 viral load and no decrease in Tcells. I have been on Atripla since it came out with no problems I am female and exercise daily and have no wasting problems, Im frightened and do not know what my next step should be, Please help me understand whats happening. Thank you

This could very well represent lab variability, although it is getting toward the high end of what we would call a blip. Given your longevity, high CD4 count and consistent undetectable viral loads, I am much less concerned. I would just have this repeated on your next visit. If it is back to undetectable than this was just a blip. If it remains detectable and/or is higher, then some viral resistance to the medications in Atripla could be developing. We usually need a viral load of >1000 in order to perform a resistance test, that would help guide changing treatment. I don't want you to get ahead of facts, but wanted to present could might happen.