Can sepsis cause viral load spike?
Jan 12, 2014
Hi Dr. Holodniy,
I'm sorry for my bad English :/. If i don't make sense, just let me know. Just recovered from bacterial sepsis - was 7 days in the icu. Now been a week since I left icu. I found out my case most likely happened because of an ignored uti.
I accidentally missed doses of Atripla the first 2 days at the icu, but took meds since then. Prior i have never missed a dose in my 3 years of having hiv. The last time I had labs was 2 months before sepsis infection, and results were cd4: 617, vl: ud. But here's the freaky thing - I just took labs Thursday and results were cd4:600, vl: 53,621! Could this be a lab error, or could the sepsis cause this vl spike? I know cd4's might fall during infection, but I didn't think i would now be detectable.
As a history I have hiv-1 for 3 years, had initial labs of cd: 327, vl: 42,002. Was undetectable the followup after initial and had cd: 406, vl: ud, undetectable since then. So it was quite surprise to see my vl be now so high because its the highest vl I've ever had.
Might you know what's going on? Possible blip? Or do blips go that high? My doctor recommends retesting, he doesn't think resistance is there because of only 2 missed doses, but will check.
Thank you dear sir
Response from Dr. Holodniy
We do know that other ongoing infections can increase viral load, even in the presence of HIV meds, although with meds, the increases are generally lower. That said, with an overwhelming infection like sepsis, the immune system is hyperactivated and could possibly turn on HIV infected cells that are dormant to start producing virus. Things should quiet down after your recovery. I agree with your doctor's plan and assessment.
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