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Possible resistance?
Oct 27, 2004

Initially (08/03), my VL was 68400, CD4 was 155/23%. I immediately started combivir & sustiva. (11/03) my VL was 481, CD4 was 680/27%. (02/04) my VL increased to 1668, CD4 & % varied little. Resistance test and blood work was done the following month(03/04) which resulted in VL <400 and resistance not detected. (6/04) VL <50 CD4 491/30%. Between nov and feb my VL increased, even with 100% adherence. Could this be a blip? I am concerned that this could be resistance, even though I am currently undetectable and resistance testing came back "zero resistance identified"

Response from Dr. Sherer

Yes, a single viral load above the threshold for detection could simply be a 'blip', particularly if the value was between 50 and 1,000 copies. You and your doctor will repeat the test and then be in a better position to decide if this was a blip or evidence of early virologic failure.

As blips are common, occurring in 40% of patients on EFV-containing regimens in one study, you should simply continue your excellent record of adherence and repeat the studies with your physician.

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