resistance and viral load

[gregftl]

i was just curious how quickly your viral load goes up when u become resistant to the hiv meds you are taking

i have been on the same meds for 5yrs.... combivir and viramune ...and since april my viral load has went from 54 in april.....550 in june and now 1800 in september. my doctor took some blood from me friday to run a resistance test but i wont get the results back for a month.

seems to me...i've read if you go off your meds your viral load exploads so wouldnt the same be true if your meds become inneffective? i mean going from 54 to 1800 in 5 months to me really doesnt bother me. a couple of yrs ago my viral load went up to 1100 during a growth hormone study and my non study dr suggested i go off the study and i did.... and my viral load went right back down. my study doctor said my other doctor was crazy for talking me out of the study because he said growth hormone really has no effect on viral load as long as u take your meds.

well..this time i'm in a study for TH9507. it is not growth hormone but a drug that naturally helps your body release growth hormone so i dont really think this is what is causing my viral load increase. any thoughts?

i have been extrememly stressed out the last few months about work so maybe that's it?

but i would think if my drugs were inneffective  my viral load certainly would have gone alot higher than 1800 in 5months

also...my tcells basically remain unchanged at 785

any suggestions or feedback would be appreciated.

[cubbybear]

seems to me...i've read if you go off your meds your viral load exploads so wouldnt the same be true if your meds become inneffective?

Hey Greg,

Going off meds and having your viral load rebound due to resistance are two different things.  When you are off your meds, there is nothing but a feeble attempt by what's left of your immune system to combat HIV.  Whereas with resistance, it varies alot depending on what drugs in your combo (one, some or all) the virus develops a resistance too, and also what type of mutations are involved and how resistant your virus is.  Regardless though, there is still *some* medication in your blood stream trying to suppress the virus, as opposed to none for someone who stops meds.

As for your viral load going to 1800 in 5 months, like i said it is possible for your virus to have developed a slight resistance, but there are countless reasons as to why your viral load may be detectable really.  Your resistance profile will soon tell.

The good thing is you have a CD4 count many of us would be envious to have!  Sorry I can't be of any more help.

Cheers
Matt

[gregftl]

that's ok i was just curious b/c i have never experienced having to change meds or anything regarding resistance personally.

my doctor i think tends to be overly cautious...which....can sometimes be a good...and sometimes....be a bad thing. i mean, she seems to even freak out when my viral load is like 75! geez back in 2000 when i first became hiv poz anything below 500 was undetectable. now u have to be below 50 to be undetectable with the more sensitive tests.

when i went in for my results last friday she immediately wanted to switch my meds without doing any further testing even though she knew in the past my viral load spiked but then again went down.

i told her that i thought changing my meds should be the last option we should go for and first asked her just to come back in a month for my normal bloodwork instead of 3months. we had done that before when my viral load spiked. she then gave me the option for the resistance test so i took that one. i mean if i dont have to switch meds then i shouldnt....even if my viral load neve drops back down to undetectable i can live with a viral load of a couple thousand ...plus or minus a little. i dont think it's time to panic personally like my dr was acting. i find myself lucky that i have been on the same drugs for 5yrs. the only change i have ever made was switching my sustiva to viramune 1yr after testing poz. i just couldnt handle the nightmares and the sustiva was causing my triglycerides to be way over 500 which is not good. i handle my meds very well..no side effects now.

i read in here alot and i notice alot of people in here, although on meds, have viral loads.....some higher than mine but dont freak out. so i know it could be alot worse. i just wish my doctor wouldnt try and send me into a panic attack!

[Eldon]

Hey Greg,

Actually, the purpose of the meds are to stop (surpress) the viral load reproduction in your system. Wait and see what the resistence test shows and follow your Doctor's recommendation to get that VL back down. The less the Viral Load the better. Please DO keep us posted on this situation.

Still not certain? Call up Newt or Gerry on this one.

Have the BEST Day!

[newt]

Greg

From 54 to 1,800 is a 1.5 log increase in the level of virus in your blood.  A 1 log increase, if it really is that, is definately significant.

Yr doc's approach is correct. One viral load test of 500 is probably a blip, but that followed by one in the low 1,000s may indicated some kind of developing resistance.  But, it could also just be a second blip.

Viral load tends to rise quite slowly to begin with if the reason is resistance, esp if the mutation in question is only reducing a drug's effectiveness rather than stopping it working completely.

- matt

[gregftl]

i know my meds are to suppress the reproduction of the virus. i've been taking these same meds for 5yrs and never miss a dose and at last resort will be willing to switch my meds. i know how difficult many meds are to tolerate so i'm lucky that i've been on the same ones for 5yrs. i guess there just is no rhyme or reason sometimes for why resistance occurs. i mean i still have unprotected sex (i always tell people ahead of time though)...i'm a bottom....so i suppose someone with resistance could have possibly re-infected me. i've read alot about that...however, i'm not an expert.... but my personal opinion is that once u are infected u are infected and cant be "re-infected" again. i think that is just a scare tactic on the part of the health care industry. but i could be just stupid, but in the 6 yrs i've been hiv poz i have had ALOT of loads up me and never gotten resistance from anyone. of course 99 percent of the people i get together with are total tops but that doesnt mean anything they could be lying about that.....and the vast majority are hiv neg but dont mind topping an hiv poz person because they know it's less risky. now, all this worry could be over nothing and it just was a blip.... but better safe than sorry. (sorry if there was too much info in that paragraph lol)

btw...i have a question about my meds. i have stored up a 4month backup supply of my meds in case of emergencies and am wondering if possibly the meds sitting around for 4 months before i take them, in a very warm room, could have some effect on their effectiveness. i know my combivir can take temps up to 87 degrees i think and it's coated, but my viramune has to be stored in a much lower temp. i have been moving them around from room to room where the a/c is on for a few months now but just wonder if them sitting around can have some effect even though they are long from being expired. any thoughts on that?

greg

[newt]

Viramune can be stored at temperatures up to 85 degrees F.

Wait for the resistance test before you sweat. 

Newer, kinder meds have been approved in the last few years. If you have to switch, you may be pleasantly surprised by the options on offer.

- matt