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Blip or something more?
Oct 13, 2002

Hi Dr. Little, I recently wrote to you to ask about my CD4 count and risk of resistence. I noted that I was having difficulty raising my t-cells above 300. I was happy to see on my last visit with my Dr. this week that my T-cells rose to 380, however there was a rise in my viral load from undetectable to just under 500 copies. My doctor said this is probably a blip. If my viral load is in fact rising would my t-cells also rise? Does one result necessarily effect the other? Also on your suggestion I did question my CD-4 percentages and they have been increasing. Thanks.

Response from Dr. Little

There is no expected association between rising CD4 and rising viral load - just the opposite. So, if your CD4 is improving and your viral load has bumped up to just under 500, I would think that this could very well be a blip. I might repeat the viral load in one month just to be more certain (I am comfortable assuming that bumps in viral load to around 200 may be blips, but higher numbers start to make me a tiny bit more concerned). If your compliance is good and your T cells are going the right direction, I would not be too worried. Transient bumps of viral load to the 200 range have not been associated with subsequent treatment failure.


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