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Viral Load Jump Up to 933 from Undetectable within 3 months
Aug 8, 2012

Hello Dr...

I've been on treatment for 2 years since diagnosed on 2010. First 13 months on Atripla and last 7 months on Truvada+Isentress

I was doing so well during that time, with previous result on May this year was Undetectable VL and CD4 505/20%. On my last appointment with HIV specialist last week, My CD4 was 368/20%, and VL jump up to 933. I never missed any single dose of my regiments since I started. I had a Flu Vaccine in May this year and never had any illness . I feel so healthy and Fit. I drink a glass of red wine every night for the last 3 months. Do you think I develop a drug resistance? Or is it possible the Flu Vaccine that I had in May could affect my VL result on Last week?

If , let say I'm resistant with my current medications , what is the best alternative? I heard that abacavir base is quite well.

Thank You

Response from Dr. Young

Hello and thanks for posting.

Your increase in viral load from undetectable to nearly 1000 is of concern. Indeed, your reporting of excellent adherence would suggest that missed medications isn't a direct cause, nor is a vaccination administered 3 or more months ago.

Once in a while, a lab error can give false results- for this reason, I'll get a confirmatory VL test along with resistance testing (in your case, it's important to determine if you have resistance to NRTIs, NNRTIs and integrase inhibitors).

If the confirmatory test reveals high-level detectable virus and new drug resistance, a next regimen is selected based on the pattern of detected resistance. There are quite a number of alternatives, and the key is to construct a regimen that has at least 2, and preferably 3 fully active medications.

Fingers crossed for you, BY



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