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Viral rebound

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.

Viral Load
long term non progressive with itp

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