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Sep 6, 2002

Hi, I recently received my viral load test. After having been undetectable for many years, it was 141. When I did the blood test, I had a small herpes infection. Could it be the beginning of resistance to my VIDEX/ZERiT/VIRACEPT combo? (I never had more than 3000 copies in my life but I started VIDEX back in 1989 (!) and Zerit in 1993, I added Viracept in 1996. I only can do a new viral load test in 2 months. (regulations here in Europe) Thanking you.

Response from Dr. Little

There is now quite good data to suggest that if followed closely enough, most people who are fully suppressed (i.e. undetectable viral loads) do have the occasional "blip" in viral load. When these values are less than 200, they have not been shown to be associated with impending viral failure or drug resistance. I would certainly make sure that you are not missing any doses, but I do not think that a viral load of 141 after a prolonged period of being undetectable should be cause for significant alarm. I think it is probably OK to wait the two months for a follow-up viral load unless there is something else (i.e. a falling CD4 count, or weight loss) to suggest that things have taken a turn for the worse. Good luck.

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