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Is this emerging resistance?
Nov 5, 2007
Hello,
I went to the doctor on Oct. 18 and had a vl of 151, CD4 574/35%. I am worried that the vl portends resistance because the last time the vl was measured in Feb. '07 it was <50. The CD4 count then was 480 and 31%. Then in July the the CD4 was 435/%unknown and vl not done b/c of a lab screw up. I just switched from sus/truv to Atripla and have never missed a dose since I started medication last year.
Also, I had a liver ALT of 67. The upper limit of normal is 60 (so said the test). What does this mean? Last time all my liver numbers were normal.
My doctor just said to come back in 4 months. What does all this mean? What happens if next time the vl is still similar?
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Response from Dr. Daar
Thank you for your posting. For most people who have repeatedly undetectable viral loads that then experience a relatively low increase, as in your case, this increase represents what is referred to as a "blip." In these cases repeat testing shows the viral load to be undetectable. I would agree with your provider that repeating the viral load is the right thing to do. I probably would do so in approximately 4 weeks just to make sure. If the viral load is still detectable and you are consistently taking your medications consideration should be given to doing resistance testing and/or modifying the regimen. Regardless, you will likely have many treatment options and do very well in the future.
The slight increase in the liver enzyme is not uncommon and probably not signficant. That said, if you have not already done so you should be evaluated for hepatitis B and C infection and minimize or avoid alcohol use. These levels should also be followed over time.
I hope this helps.
Best,
Eric
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