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Making Sense of High Viral Load Results
Apr 11, 2004

Hi - first, like many people on here, I want to thank you for all the work that you do - this site was recommended by my doctor when I was first diagnosed and it's been a great source of information and comfort.

My question is about my viral load tests - I was diagnosed on 10/29/03 with an ititial VL of 109,350. Subsequent test on 11/06 was 333,297 and 11/20 was 231,310. Enrolled in a study (ACTG5142 - Sustiva and Kaletra) and began treatment on 11/25 - also had another VL test that day before medication began and the result was 970,648. Since then monthly VL results have been 183,077, then 5,437, then 500, then 181. CD4 count has gone from 507 on 11/06 to 701 this past February. It all seems really good - but I'm not sure what to make of the 970,648 VL - doesn't that seem abnormally high and a huge increase from 5 days earlier when it was 231,310? I had a series of relatively minor infections just previously to diagnosis (wisedom teeth), but thought I was relatively healthy at the time of the VL test. I'm just trying to understand my history a little better, and any insight you could give me would be appreciated. Thanks!

Response from Dr. Young

Thanks for your question, and more importantly, thank you for participating in the clinical trial.

The way that I'd look at your numbers is that there is a lot of variation in viral loads in persons who have not yet started on treatment. There could be up to a 5-fold change, without any significant change in medical status or prognosis.

Looking then at your numbers, you can see that if you average your first several viral loads, they all cluster around 250,000. The nearly 1 million value could have represented some kind of immune activation, like a cold or vaccination, but could easily just have been on the wider side of normal variations.

Hope this helps, thanks for reading. BY



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