Jan 18, 2009
I am 59, started meds at a CD4 count of 260 in April, VL 6,000. No missed doses. My first post HAART labs showed a rise to 320 CD4, VL 1000, the next labs: 360 CD4 VL UD. My last labs last week showed a CD4 of 460 with VL of 250. My provider says it's probably a blip and wants to repeat it in a month. I contracted a complicated virus and am on a boosted PI with Truvada, There was a lot of discussion when I started meds if more should be added because of the confusing genotype/phenotype picture but it was opted to start with a "basic" regimen.
If the VL stays detectable but too low for a resistence test what is done then? Isn't it fairly early for blips? Do they occur much more often in some than others? When blips are frequent or early can that mean that med resistence is likely?
Response from Dr. Holodniy
Blips can occur any time after becoming undetectable. It is hard to predict who might have blips and or how often. In studies done to date, the likelihood of HIV med failure is low regardless of how many blips one has as long as the viral loads remain below 1,000. That said, you don't indicate what the resistance tests showed and whether the regimen you are currently on is 100% active. It may require a medication adjustment if the viral load remains positive above 500 or if increases above 1,000.
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