Jun 9, 2013
Dear doctor Holodniy,
I am 27, HIV+ MSM and concerned about my last results. I was diagnozed in Jan 2012 and am on Truvada + Stocrin since May 2012. My last results before the treatment (May 2012) were CD4 472 and VL 117,000. After three months on cART CD4 jumped to 720 and VL dropped to 26 (Oct 2012). I was very pleased with the result.
My last lab (Apr 2013) was still very positive according to my doctor but I dont feel so secure: CD4 636 and VL 40. I expected being undetectable (<20 in my country). Doctor thinks this is related to emptying hidden reservoirs and unless I reach 100-200 copies/ml I should not be worried because my other results are excellent.
What might be the reason why I cannot reach undetectable levels according to your opinion? I take 100% of my daily medications and very rarely later than 60 minutes +- from the time I am supposed to.
Thank you very much in advance for your answer.
Response from Dr. Holodniy
I agree with your doctor's conclusions. I think you have had an excellent response. The data surrounding subsequent virologic failure in those with viral loads between 20-50 copies/mL is still controversial. Although some can have virologic failure, others do not. We don't know all the characteristics of those who might fail, such that we could predict who might and who might not have subsequent failure.
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