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After !0 Years Now Detectable
Jul 5, 2014

I have searched the questions and answers and am still confused about my last three labs. Back in 2003 I started out with a cd4 count of 50 and a viral load over 1 million. While in a study and on meds my viral load became undetectable <20 in just a few months and my cd4 count slowly raised over the years (took me forever to bust 100 dc4 count). All of my labs were done through the study I was on. Now with the study over and my labs being done through my HIV doctor the two test done with him was detectable but <20. My last tests were viral load detectable and 56 and my cd4 count was 495. I'm very happy about my cd4 count but concerned about being "detected" and viral load of 56.

My doctor doesn't seem concerned and I'm not sure if the way my tests are being done now are more sensitive so it can detect viral loads lower than what was done before. Either way I've only missed my meds twice in then years and hope that the trend doesn't mean I've become resistant.

Response from Dr. Holodniy

First, I agree with your doctor and I am not concerned. Current viral load assays have now been recalibrated to be able to detect, but not quantify viral load < 20 copies/mL. This has created a lot of problems for practitioners and patients as to what that means and if it means that current HIV treatment is no longer effective. The published literature is mixed on what this all means. Some studies indicate there is a higher rate of failure if any virus is detected and other studies have not shown this. It does not appear that adding additional HIV meds results in completely undetectable/unquantifiable HIV viral load. So most of us are just watching patients closely but not doing anything at this time.



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