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Author Topic: Virus replication capacity  (Read 1241 times)

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Offline milker

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Virus replication capacity
« on: May 05, 2007, 11:06:34 AM »
I was reading my phenotype report and was very pleased, until I saw: RC 160%  >:(

I have HIV1-B, the wild type, and I understand that the wild type has a RC of 100%. So is 160% bad  ???

Milker.
mid-dec: stupid ass
mid-jan: seroconversion
mid-feb: poz
mar 07: cd4 432 (35%) vl 54000
may 07: cd4 399 (28%) vl 27760
jul 07: cd4 403 (26%) vl 99241
oct 07: cd4 353 (24%) vl 29993
jan 08: cd4 332 (26%) vl 33308
mar 08: cd4 392 (23%) vl 75548
jun 08: cd4 325 (27%) vl 45880
oct 08: cd4 197 (20%) vl 154000 <== aids diagnosis
nov 2 08 start Atripla
nov 30 08: cd4 478 (23%) vl 1880 !!!!!!!!!!!!!!!!!!!!!!!!!!
feb 19 09: cd4 398 (24%) vl 430 getting there!
apr 23 09: cd4 604 (29%) vl 50 woohoo :D :D
jul 30 09: cd4 512 (29%) vl undetectable :D :D
may 27 10: cd4 655 (32%) vl undetectable :D :D

Now accepting applications from blowjob ninjas™

Offline Miss Philicia

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Re: Virus replication capacity
« Reply #1 on: May 05, 2007, 11:15:53 AM »
I have 118%, and the "range" (not sure what exactly they mean by that) is 75-188% so yeah I guess yours is high.  Nobody talks about this part of their testing much.  I remember when ViroLogic first came out with it and offered it for free with my last doctor I had before moving here... must have been around 2002.  I don't have copies of those older tests (the one I'm looking at now is my last one done 2 years ago with my current doctor), but I'm quite sure my number at the time was much lower.  Considering that 4 years ago my VL was still not suppressed having this lower VRC number seemed to cheer up my doctor as I was by then showing a total mutation to all PI's.
"I’ve slept with enough men to know that I’m not gay"

Offline milker

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Re: Virus replication capacity
« Reply #2 on: May 05, 2007, 11:20:05 AM »
Well the good thing is that the phenotype report shows susceptibility to all drugs. Is the VRC something that can change by itself, hopefully going downwards, or does it stay the same until you get on drugs?

I'm not sure I understand why my virus replicates faster if it is the wild type  ??? Maybe Gerry will explain :)

Milker (who is lazy and was hoping for a lazy virus)
mid-dec: stupid ass
mid-jan: seroconversion
mid-feb: poz
mar 07: cd4 432 (35%) vl 54000
may 07: cd4 399 (28%) vl 27760
jul 07: cd4 403 (26%) vl 99241
oct 07: cd4 353 (24%) vl 29993
jan 08: cd4 332 (26%) vl 33308
mar 08: cd4 392 (23%) vl 75548
jun 08: cd4 325 (27%) vl 45880
oct 08: cd4 197 (20%) vl 154000 <== aids diagnosis
nov 2 08 start Atripla
nov 30 08: cd4 478 (23%) vl 1880 !!!!!!!!!!!!!!!!!!!!!!!!!!
feb 19 09: cd4 398 (24%) vl 430 getting there!
apr 23 09: cd4 604 (29%) vl 50 woohoo :D :D
jul 30 09: cd4 512 (29%) vl undetectable :D :D
may 27 10: cd4 655 (32%) vl undetectable :D :D

Now accepting applications from blowjob ninjas™

Offline gerry

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Re: Virus replication capacity
« Reply #3 on: May 06, 2007, 01:40:43 AM »
Milker

No one really knows how to interpret replication capacity when it is reported on someone who is not on treatment and has no drug resistant mutations.  There was one study that investigated replication capacity in acute HIV infection and reported correlation between replication capacity and steady-state CD4 count once the set point is reached after the primary infection.  However, when replication capacity is reported after the set point is reached, there is really no information how to interpret this.  There is also no known correlation between replication capacity and response to antiretrovirals when one is at the point of needing to start treatment.  So I would not really worry about this number in your situation.

Replication capacity is being investigated more actively in people who are highly treatment-experienced.  Certain drug resistant mutations occur at the expense of the virus being less able to replicate efficiently (i.e., lower replication capacity).  In other words, there is a cost to the virus' ability to replicate when these drug resitant mutations are induced.  Because the virus is less fit, there is consequently a lower rate of CD4 decline.  This is important when making clinical decisions as to what to do in highly treatment-experienced patients who have failed treatment due to development of drug resistance with viral loads remaining detectable and have little options of switching treatment to achieve undetectabilty other than to wait for newer pipeline drugs.  Should the treatment be continued in spite of failure so as to support the mutant virus that is replicating less efficiently thereby causing less CD4 decline, at the expense of possibly developing more resistant mutations which might affect future drug choices?  Or should treatment be stopped to avert more mutations, after which the wild type virus which is more fit would once again repopulate and cause more rapid CD4 decline?  These issues are being investigated actively, but they are not necessarily relevant to your situation at the moment.

Gerry

Offline milker

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Re: Virus replication capacity
« Reply #4 on: May 06, 2007, 09:53:59 AM »
As always, Gerry, very good explanation, thank you :)

Milker (who stopped replicating anxiety)
mid-dec: stupid ass
mid-jan: seroconversion
mid-feb: poz
mar 07: cd4 432 (35%) vl 54000
may 07: cd4 399 (28%) vl 27760
jul 07: cd4 403 (26%) vl 99241
oct 07: cd4 353 (24%) vl 29993
jan 08: cd4 332 (26%) vl 33308
mar 08: cd4 392 (23%) vl 75548
jun 08: cd4 325 (27%) vl 45880
oct 08: cd4 197 (20%) vl 154000 <== aids diagnosis
nov 2 08 start Atripla
nov 30 08: cd4 478 (23%) vl 1880 !!!!!!!!!!!!!!!!!!!!!!!!!!
feb 19 09: cd4 398 (24%) vl 430 getting there!
apr 23 09: cd4 604 (29%) vl 50 woohoo :D :D
jul 30 09: cd4 512 (29%) vl undetectable :D :D
may 27 10: cd4 655 (32%) vl undetectable :D :D

Now accepting applications from blowjob ninjas™

Offline DavidinCA92284

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  • Posts: 45
Re: Virus replication capacity
« Reply #5 on: May 06, 2007, 06:59:25 PM »
As I understand it, Replication Capacity test determines the likelihood that the virus will replicate without the presence of drugs in the system.  Therefore, the prior response doesn't make much sense to me.  In other words, a 100% result, which is what my test indicates, tells me that if I go off my meds, the virus will replicate at a modest clip and therefore I need to be on meds the rest of my life.  However, if I had a 160%, it would indicate that if I go off meds, then the virus will replicate at a quite faster rate than someone with a 100% score and therefore the requirement for adherence and taking the drugs would be even more important.  The higher the RPC, quite possibly the faster rate of replication, mutation.    A result on the low end - 55% or so, means that someone mgiht be able to be off of drugs for a considerable amount of time without replication being a major problem.

 


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