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Increased CD4 and Increased Viral Load
Jul 6, 2013

Hi Dr. Mark,

My partner just got his most recent labs back and was upset to discover that while his CD4 count went up from the high 280s to around 310, his viral load went from being undetectable to 560. He'd been undetectable for around 18 months. The doctor did some more blood work today to find out whether this was due to an error, but in the meantime both of us are worried. He's been on Complera for over 2 years, most of which was during a trial that monitored adherence, and he is extremely vigilant about taking his meds every day, so this potential development is especially frustrating and depressing. If the increase turns out not to be an error, would this be an indication of resistance?

Thanks, A Worried Partner

Response from Dr. Holodniy

The most important thing was to repeat the labs when you get something like this happening. I think if the repeat shows the same or higher viral load then you will have the answer that resistance and or possible treatment failure is more likely. The current viral load is still pretty low, such that resistance testing is unlikely to be performed, as most reference labs like the viral load to be over 1,000 for performing the test. If changing the regimen becomes necessary, there are many options available for him.



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