Hi Dr. Holodniy:
I've been + for 22 yrs. Since 1996 I've NEVER been detectable ... until now. Before 2010, my health group tested to <72. Since then <48.
I switched from Tivicay/Truvada to Tiv/Descovy in Aug 2016. Before switching, VL Always: < 48. But then Four mos. later (Dec): 105. Jan 2017: 74. Mar: 102. May: 103. Aug: 50. Dec: 303.
My Dr. says don't worry. These are only blips. If you were failing your #'s would steadily jump up. He said a genotype resistance test would be a waste of time.
How could these be "blips" when my VL has consistently (6x's in a row) been detectable?
I never miss doses. Why would switching from Truvada to Descovy cause this to happen? The switch is the only variable I can think of that would account for the detectable VL.
Aren't I more likely to "fail" if my VL is consistently detectable [Vs <48] ... even if it's less than 300?
Thank you for your time.
I agree with your conclusions and see this as a trend of consistently being positive and not blipping. Although it appears the timing of these detectable viral loads occurred after switching HIV meds; the only difference between those two regimens is the form of tenofovir in Descovy, which should have not had any effect on regimen potency and therefore your viral loads should have remained undetectable. Although it is true that a standard HIV resistance test in blood plasma can't be performed because the viral load is too low (it needs to be > 500 copies/mL), that doesn't mean that a resistance test would not have value. However, a test called GenoSure Archive could be done, as it tests for resistant virus inside blood cells, and doesn't require a detectable HIV viral load to be performed. I would also check to see you are not on any other medications that might be interacting with your HIV meds to lower their levels and therefore effectiveness. I think for now, you don't need to switch HIV meds or do anything yet. I would wait to see what the next HIV viral load result is. If undetectable, nothing to do. If further increased or still detectable above 200, I would get the resistance test and see whether HIV meds need to be adjusted.