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Virus Load Detectable
Dec 4, 2009

I'm devastated, having just returned from my HIV Specialist appt. In Aug 2004 I came down with PCP, was put on different meds, accepted the fact that I have AIDS, recovered and have been taking Atripla for several yrs now with "no detectable virus load". I do blood work each 6 months and now have a CD4 count of 482 (Nov 2009)...my doc says that is good. But I also found out today at my appt, that my Virus Load is "107". I'm scared and frighten. My doctor wants me to do blood work again in 3 months (Feb 2010) and see if the virus will rise or become undetectable again. Why is my virus load detectable now after about 5 years of being undetectable? Did I mention that I'm really scared? Should I be doing anything else in the next several months? I exercise daily, try to eat a low fat diet and don't drink. What could be going on with the virus??? Is the wait and see the best path at this point or should I be thinking of changing my "meds". Thank you so much for the valuable information you provide to all of us living and aging (I'm 59) with AIDS. an Oldie with AIDS

Response from Dr. Henry

A low level viral load such as 107 copies/ml is called a viral blip (you can google that to get some other background info). Such blips are seen fairly often and generally do not indicate a loss of viral control but rather a combination of occasional release of extra virus from reservoir sites (still controlled once in the blood by the HIV drug) or variations in the technical performance of the viral load assay. In patients who have a high level of adherence to their drugs in most cases the viral load drops back down to undetectable at the next visit. In studies of patients with viral blips in general they have done well over time (many years) and often compare well to patients without such blips. Resistance generally doesn't develop in association with blips (defined most often as transient viral loads going above the detection limit to around 500 copies/ml. Rechecking in 1-3 months is often done with the level of concern raised (and resistance testing performed) if the level remains > 75 copies and particularly if > 500-1000 copies/ml. KH



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