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Making Sense of High Viral Load Results
May 2, 2004

Hi - first, like many people on here, I want to thank you for all the work that you do - this site was recommended by my doctor when I was first diagnosed and it's been a great source of information and comfort.

My question is about my viral load tests - I was diagnosed on 10/29/03 with an ititial VL of 109,350. Subsequent test on 11/06 was 333,297 and 11/20 was 231,310. Enrolled in a study (ACTG5142 - Sustiva and Kaletra) and began treatment on 11/25 - also had another VL test that day before medication began and the result was 970,648. Since then monthly VL results have been 183,077, then 5,437, then 500, then 181. CD4 count has gone from 507 on 11/06 to 701 this past February. It all seems really good - but I'm not sure what to make of the 970,648 VL - doesn't that seem abnormally high and a huge increase from 5 days earlier when it was 231,310? I had a series of relatively minor infections just previously to diagnosis (wisedom teeth), but thought I was relatively healthy at the time of the VL test. I'm just trying to understand my history a little better, and any insight you could give me would be appreciated. Thanks!

Response from Dr. Young

Thanks for your questions and kind words.

The key element to the answer to your question is the recognition that in the untreated person, viral loads may vary as much as 5-fold without any significant reason. There does seem to be a rather large variation in your values, but a change from 230,000 to 970,000 is within this 5X range.

Minor infections (like colds or sinusitis) also can affect viral loads, so if you factor all of these together, I find that the range in your viral loads to be well within expectations.

Either way, you do have a rather high initial viral load, but it would appear that you're having a very nice response, both virologically and immunologically to your HAART therapy.

Lastly, thanks for participating in the clinical trial. We all benefit from your volunteerism. BY



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