Hi, I have been on atripla since April of 2009. When I started my stats were VL 99000 and CD4 of 582. I had labs done in Dec 2010 and my VL was UD with CD4 of 1056. In April of 2011 my labs were VL 56 and CD4 of 1053. My doc informed me that it was a blip and that I should have labs done in a month. In May 2011 i had labs and my VL increased to 116 and my CD4 also increased to 1300. I am confused as to why my VL keeps increasing while my CD4 also increases. Is it possible to have 2 'blips' in a row? What is the way forward? I have been adhering to my meds so it is possible that I have a resistance to one component of atripla?

Hi.

Your two detectable quantitative HIV plasma RNA PCR viral loads were only one month apart and were characterized by a very low viral load (56 and 116). This could be all part of a single blip or two mini blips. Either way I see no cause for alarm. You are adhering to your Atripla regimen and it has been very effective, both immunologically (CD4 rise from 582 to 1,300) and virologically (viral load plummeting from 99,000 to undetectable). If drug resistance were developing, you would see a steady and significant rise in plasma viral load and then a corresponding decline in CD4 count and CD4%. I would advise you repeat your viral load in two months. If you are undetectable, you can rest assured your previous values were just blips. If your viral load rises significantly, you'll need resistance testing.

I'll post below a link to information about "blips" from the archives.

Good luck.

Dr. Bob

First blip! - Should I worry. (BLIPS, 2010) May 7, 2010