I was infected in october 2008 initial Vl was 2.7 million and cd4 of 296, started atripla in april 2009 and by June 2009 vl was about 90 cd4 about 700 in Jan 201 vl still around the 100 mark and cd4 596 my doctor switched me to reyataz, norvir, truvada my last cd4 on september 2010 was about 600 50% and vl 320 i've had a herpes outbreak since june 2009 which i take famcylovir 500mg x 2 die which does not supress the virus it never lets up. Do you think this is the cause of the persitant Vl and if so what would you reccomend thank you. Steve

Hello Steve and thanks for your post.

Low level HIV viremia can indeed be caused by having immune system activation from herpes infection. It might be worth finding out if your outbreaks are really herpes. A viral culture or PCR test could be performed; the former could also allow testing of the live virus to determine if your herpes is sensitive to herpes medications.

I hope this is helpful to you, BY