Sudden jump in viral load...

Jul 28, 2000

My viral load recently jumped to 635 (on 7-5-00) from less than 26. The last time it was greater than 26 was on 4-15-99 when it was 4880. The only recent change in meds and routine has been the addition of Oxandrin because of weight loss (>20 lbs.) and the start of an exercise program three times a week. What might be the cause of this sudden jump, could this be the beginning of resistance? Or is this just a fluke in the lab test?

My doctor has ordered a HIV-1 Genotype (RT & PI) test to be done in a couple weeks. T-Cells have remained steady in the 200’s since February of this year.

HIV infection since February 1999.

Current meds started 2-23-00; Viracept 1250mg 2 x day, Combivir (AZT & 3TC) 150mg/300mg 2 x day, 5-26-00 started Oxandrin 10mg 2 x day

Drugs 2/99 through 2-23-00 (changed when neuropathy was noticed in feet); Viracept, Epivir (3TC), Videx (ddI), Zerit (d4T)

Thanks for any help and advice you can give.

Response from Dr. Holodniy

There is still some conflicting info on what these increases may mean. If on repeat, your viral load is back down, then this was a "blip". These are probably not virologically or clinically meaningful according to some studies following patients for over a year. There has been some data indicating that virus in cells may be developing new mutations with these blips. This has not been seen in the plasma virus that we use for genotyping. If on the other hand the viral load is higher, it may mean the development of resistance. It's unlikely to be the Oxandrin.

MH