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Question about VL and Drug resistance
Aug 5, 2006

My VL has been undetectable since taking meds about 8 years ago. I have been adherent fully but just now the latest VL test had VL at 100,000. My MD said: Impossible with full adherence might be a lab error, so we will do another VL test.

IS THIS TRUE? Can the virus "break through" with full adherence?

Response from Dr. Daar

Thank you for your post. I believe it is somewhat unsual for someone to be undetectable for as long as you to then suddenly experience virologic failure while consistently taking their meds. Nevertheless, it certainly can occur and does require follow-up laboratory testing. Other scenarios can also be associated with transient increases in viral load, although 100,000 copies/mL is a little higher than usual. Examples include development of any one of a number of acute infections such as herpes, or possibly in association with an immunization.

The most importnat thing is that you need to have the test repeated and if it is undetectable great, if not you should have resistance testing performed in order to decide on your next regimen.

Best, Eric


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