May 13, 2012
Dear Dr. Holodniy,
Thank you all for the great work you and your colleagues are doing on this site. It is my primary resource for any questions I have on HIV and it has helped me a lot to get informed and to cope.
I am a 40 years old HIV+ European male living in Japan. I have been diagnosed with HIV when I was hospitalised with toxoplasmosis and lung infection here in Japan about three years ago with a CD4 count of 138 and a VL of 190,000.
Since about 2,5 years I am on Atripla and have reached undetectable viral load (<20 cc/ml) around 9 months after initiating therapy. My CD4 cell count is currently around around 640 with a CD4% of 31.
I am 99.9% adeherent and have only missed a dose once. On another occasion I have doubled a dose. Other than that I am taking my drug within a 1.5 hour window between 10pm and 11:30pm.
My last blood work (End of Mar.) came back with a VL of 26. I am confused about this. My Doc in Europe who is a reknown HIV expert tells me that this is probably not even a blip but may very well be a laboraty issue or a very low level viral replication situation that just happened to be slightly above the level of detection and may have disappeared an hour or so later. I am doing all my blood work and receive my HIV care in Europe every 3-4 months and also have a Doc here in Tokyo who is connected with my EU Doc and helps whenever necessary.
I am planning my next Docs visit in Europe in early Aug. Should I go earlier to follow-up on the viral rebound?
I appreciate your response.
Best regards from Tokyo
Response from Dr. Holodniy
I agree with your doctor's conclusions and would not be concerned. You can wait until August.
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