Hi,

I was diagnosed in 2007--VL has been steady around 60,000, T-cells between 500 and 700. Three months ago, VL fell to 30000 but T-cells to 472. Last week, VL jumped to 500,000 and T-cells were only 390.

I'm sure it's time for meds, but what could cause such a jump in VL? Also, my office has paid for an expensive overseas training trip which would keep me from starting meds for the next three weeks. It would be difficult to cancel and raise a lot of questions I hope to avoid.

I feel OK (a little flu-ish). Am I risking it to go on the training, or should I find some way to get out of it and start meds right away? My doctor said he's comfortable with waiting the three weeks, but I'd like another opinion.

Thanks for the great service you provide here.

Hi,

Your jump in HIV plasma viral load could be due to any of a number of factors: lab error, superinfection, viral evolution, concurrent infection, etc.

I agree with your Dr.: Waiting three weeks to begin your combination antiretroviral regimen is perfectly reasonable. I would repeat your viral load and CD4 count as well as obtain a genotype for resistance testing before constructing and beginning the regimen.

Good luck.

Dr. Bob