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Am I out of the water?
May 24, 2002

I have been on Combivir/Sustiva therapy for 2.5 years. My VL has been undetecable and CD4 has risen from 50 to 450. About a month ago my most recent labs came back VL=1500 CD4=500 I've never missed a dose. I retook the test and VL is undetectable again. Is this the beginning of treatment failure or is the treatment still working. Dr. doesnt seem to be concerned, but from what I've read a VL of 1500 is beyond the "blip" range. Am I out of the water or should I be concerned?

Response from Dr. Boyle

Well, there are other reasons for an isolated viral elevation than just viral failure or blips, and these include lab error, sample handling errors, vaccine administration, intercurrent illness and other problems. If you are back to <50 copies/mL, I would suspect one of these, because you are right that a viral load of 1500 is not what would usually be considered a "blip". I would, however, recheck you relatively soon and confirm that your are well suppressed, and staying there.

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