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Low load confuses resistance tests ?
May 27, 1999

I have been HIV + for 10 years, no PIs just NNRTIs so far.

Never had a detectable viral load (since 94). T cells etc are stable at about 750 ratios good. I have had blood cultures that cannot culture virus within the last two years. Just to satisfy my curiosity, I have a resistance test run, and much to my suprise it came back with results showing resistance to a few of the NNRTIs, including some I've never taken. How is the test affected by very low serum virus levels ? How are they able to get sufficient sample to do the phontyping ??

Response from Dr. Holodniy

I assume that undetectable for you is < 400 copies/ml and not <50/ml, in which case it is technically possible to find enough plasma RNA to do resistance testing. In those with < 50/ml, it is extremely difficult. Certain mutations in the reverse transcriptase gene confer class resistance to NNRTIs, so the result that you have resistance to some you have not had exposure to is not surprising.


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Viral Load in HIV-1 and HIV-2

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