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Trofile Blood Test

Jul 8, 2012

Dr. Holodniy: Thanks for your prior reply in regard to Lymphocyte %. Although I had a great response to the Truvada/Isentress, (after much "internal" debate), I decided to stop the meds on 7/3/12. I was having worsening CNS side effects (feeling sedated, causing depression,difficulty with memory,fatigue and inability to maintain concentration at work). When meds stopped my VL was "undetectable": CD4 was 489 and 37%. The ID specialist is speculating that it may be the Tenofovir that is causing the problem and said I could try Emtriva/Isentress/Selzentry. I will have the Trofile done when my VL should be > 1000:

1. First diagnosed in 11/2011: VL=46000 CD4=374 20% Would you think that my VL would go over 1000 in 3 weeks from 7/3/12? (possibly only take 2 weeks?) 2. I've read that when first infected the cells usually start out as R5 but can then switch to the X4 tropism as infection spreads. Since my doc feels I had been positive for 3-4 years prior to 11/2011, would you feel that the Tropism results would be accurate and stay the way the are rated: (R5, X4 or mixed)?

I know the blood test results will take at least 2 weeks and I want to get it done as soon as the VL will be high enough to ensure validity of the results. Thanks for reading all this!

Response from Dr. Holodniy

1. Yes, I believe it would rebound within that time frame. 2. The trofile test can be performed on virus in the plasma, or from the DNA form of HIV in blood cells. So, if the trofile DNA test were ordered you would necessarily need to be off meds or wait for a viral rebound. It is likely given your history that you will have a R5 only result.

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