oh no , stopped worrying and now worrying again..Viral load

[motherinneed]

My son just went to the doctor to review his labs. His CD4 is 433 so it went up significantly. His T cells are still undetectable. He is very compliant with his meds. Atripla but due to his schedule changing alot he may have taken the med an hour late several times. I did not think that one hour could cause a problem with developing resistance...Can that one hour cause resistance? He is thinking he is going to die sooner now. I am trying to be calm around him but I want to scream and cry as I do not want to lose my son or see him suffer. The doctor wants him to take labs again in december. Isn't that too long of a wait, what if he is resistant and he waits till december? That scares me. The MD did say if he gets too worried he can do the labs earlier. Should I be spazing out with worry or do I need to calm down as there are alot of meds out there he can use if he is resistant. He also recently had a cold but did not have the cold when he had his labs.. could this have effected the CD4?
Lots of questions, please someone give me some insight as I am trying not to cry.
sincerely,
motherinneed

[Ann]

Mother,

Yes, you need to calm down. 433 is a very good number. He's not going anywhere anytime soon. Relax!

When taking Atripla and undetectable for as long as your son has been (going by your posts, it's a couple years, at least) an hour isn't going to make a bit of difference. Stop worrying that he's going to become resistant just because he's not taking them bang-on 24 hours apart.

The most important thing is that he's taking them every day. The timing at this point isn't that important, it's the overall regularity.

He's going to be just fine, so dry your tears.

Ann

[motherinneed]

Thank you Ann.

[Ann]

Mother,

Two things I missed out in my first post...

Colds and things can affect CD4 counts - BUT - as your son is on treatment, the most important thing is that he remains undetectable. CD4 counts can and do fluctuate on an hourly basis, so don't worry too much about them.

People who are on treatment and stable (and your son IS stable) go anywhere from between three to six months between appointments. The trend these days is to have people such as your son go between four and six. When a person has been undetectable for as long as your son has been, and is good about taking their meds everyday, there's really no reason to go more frequently. Of course, it also depends on how comfortable the person is with waiting. If something comes up between appointments, he can always make an interim appointment to get whatever is worrying him checked out.

He's going to be fine. Really.

Ann

[motherinneed]

Dear Ann,

His viral load is now 133, is was undetectable before
CD4 439

okay since the viral load is higher, now is it a resistance to the medication?
need you input.
thank you.

[Ann]

Mother,

This is most likely what we call a "blip". And NO, it does not automatically mean resistance.

OK, look at it like this. The reason VL tests are not used as a tool for diagnosing hiv is because they are prone to FALSE POSITIVE results. What this means is that a person who absolutely does NOT have hiv can have a VL test done and have it come back with a detectable viral load. These false positive results are typically under 1000. This is most likely what has happened in your son's case.

If you look through these forums, you'll find PLENTY of cases like this where someone who was previously undetectable had a blip. In the majority of cases, the next VL test comes back undetectable. In fact, I can't remember this not being the case in someone who is compliant (takes their meds every day) like your son.

What's usually done in a case like this is another VL is done on a fresh batch of blood, usually within one to four weeks.

From what you told us in the other thread, I do not expect this to be anything other than a blip. They happen.

And his CD4 is fine.

Also, I'm going to merge your threads. Please try to keep follow-on posts like this in with the original thread where you first brought the concern/subject up. It just makes it easier for people to follow what's going on and therefore offer pertinent comments.

Ann


edited to fix annoying typos

[motherinneed]

Thank you.
sorry I was going to continue in the same thread but then I thought the old thread was ended so I started a new one. Thanks for fixing that..
Thank you again for your quick responses.