Yo-yo viral burden results
May 1, 2000
My viral burden results have been going up and down, jumping from non-detection 4 months ago to 100, 0, 70 and 190 copies (by branched chain test). My physician sent my last 2 blood samples to retest with polymerase chain test and they both came back negative. I am very loss and worried. Should I wait for the next visit and which test should I trust? Is there a possibility of resistance?
Response from Dr. Holodniy
The low level positive results can be the result of: ongoing viral replication (regimen has lost some potency, with a possibility of resistance), intercurrent illnesses, assay variability. You didn't indicate whether your CD4 count/percentage had changed over this time. It wasn't clear whether the PCR test was an ultrasensitive (50 copy cutoff), or regular PCR viral load (400 copy cutoff). The current bDNA and ultrasensitive PCR test track fairly well. If they used a regular amplicor PCR test, it would show negative, and the bDNA positive. In any case, I wouldn't do anything yet. In these cases, I follow the trend in viral load and CD4 counts closely.
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