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Viral blips

Jul 2, 2004

I have been HIV+ for exactly one year and 6 months. I started HAART therapy with 90 days of being exposed, when still seroconverting. Due to side effects I have gone through at least three different regimens until arriving at one that I experience no side effects with: Viread, Emtriva, Viramune. I never miss a dose. Up until recently, my viral load has remained undetectable and my CD-4's have risen from a low of 129, when seroconverting, to around 450. However, my labs done in March showed a detectable viral load of 520 copies. Six days later I had another test done and my viral load was undetectable. My doctor and I attibuted the blip to a bad case of poison oak that I had suffered shortly before my blood was taken the first time. What is concerning me is my most recent labs, taken last week, show a detectable viral load of 119 copies. My CD-4's are at 460 and CD-4/CD-8 ratio is up to 1.5. My doctor is not concerned about the detectable virus and says it's too low to cause resistance. He says to just stay away from the poison oak.(It grows everywhere on our property and you can get it just petting the dogs) I just wanted a second opinion of whether or not to start a new regimen.

Response from Dr. Pierone

I don't think you need a new regimen. One of several things may happen. First, you may never blip again and simply stay undetectable. Second, you may blip occasionally. Third, you might develop chronic low level viral control with HIV RNA readings in the 100 to 1000 range. Lastly, you might develop overt viral breakthrough at which time you can get a genotype or phenotype and see what resistance is present.

I would wait it out and see what happens over the coming year. Depending on which course you take, you can defer major decisions until that time. Best of luck.

Hope for gene therapy
first PI based and then switch to NNRTI?

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