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Author Topic: Viral Load Going Up?  (Read 2956 times)

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Offline northernguy

  • Member
  • Posts: 1,347
Viral Load Going Up?
« on: August 25, 2010, 12:04:05 PM »
 ??? Got some bad news in my latest labs.  My viral load is going in the wrong direction - up to 205 from 60 last time.  So I've never reached undetectable after 8 months on Atripla.  What a bad way to start my day with this info from the hospital.  :'(

At least cd4 and % were up a bit to 680 and 27%.
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Offline phildinftlaudy

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  • Posts: 2,961
  • sweet Ann what you think babe...
Re: Viral Load Going Up?
« Reply #1 on: August 25, 2010, 12:08:07 PM »
??? Got some bad news in my latest labs.  My viral load is going in the wrong direction - up to 205 from 60 last time.  So I've never reached undetectable after 8 months on Atripla.  What a bad way to start my day with this info from the hospital.  :'(

At least cd4 and % were up a bit to 680 and 27%.
Sorry to hear about that northernguy -
Maybe it is just one of those "blips" that occurs every now and then.
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline Miss Philicia

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  • Posts: 23,990
  • celebrity poster, faker & poser
Re: Viral Load Going Up?
« Reply #2 on: August 25, 2010, 12:11:17 PM »
It's not like an explosion, though yeah we'd prefer it go in the other direction.  I've seen some people on here that have taken 8-12 months to get to undectable with Atripla, and I guess Sustiva is sometimes slower like that.  I don't think a PI-regimen would be that slow.

If this really bothers you then just ask your doctor to 1) retest in one month and 2) ask him for a "deadline" to get to UD, like a year from start date, so that's in another 3 months.  If it's not working by then you can always insist on making a complete change.

ps: it wasn't so long ago anyway that both 205 and 60 were considered "undetectable" just to keep things in perspective numbers wise.
"Iíve slept with enough men to know that Iím not gay"

Offline MarcoPoz

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  • Posts: 396
Re: Viral Load Going Up?
« Reply #3 on: August 25, 2010, 12:39:43 PM »
Northernguy,

Take heart, this really could just be a 'blip'.  It could be something as simple as a co-occuring infection or the natural variance being seen due to the time of day the sample was taken.  It could also mean you might be dealing with some resistance.  How's your medication adherence? 

Talk to your ID doc and see what you two come up with as next steps.  The old 'undectacable' was under 500--we were glad when we reached it.  The sensitivity of the tests are getting better--knowledge is power and you may be seeing something early that you can act on now.

Hang in there.

Offline ad2san

  • Member
  • Posts: 186
Re: Viral Load Going Up?
« Reply #4 on: August 25, 2010, 01:16:02 PM »
don't forget that the machine may have given wrong info ...
I assume that your doc wants to check your lab soon  ???
Feb   2009 CD4 358 VL 2000 16%
May  2009 CD4 305 VL 3069  14% <---- Started TVD+ATZ/r
Jul  2009 CD4 512 VL <50   18%
Jul 2010 CD4 418 VL <50 24%                     
Switched to Kivexa (Epzicom) + Norvir + Reyataz (due to sleep problem)
Aug 2010 CD4 606 VL <50 25%
Apr 2011 CD4 523 UD 21%
Jul 2011 CD4 494 UD 23%
Switched to Kivexa (Epzicom) + Viramune XR (due to kidney problems)
January 2012 CD4 564 UD 31%
October 2012 CD4 684 UD 29%
January 2013 CD4 594 UD 26%
Switched to Kivexa (Epzicom) + Isentress due to BIG increase GammaGT
Feb 2013 CD4 699 UD 28%
May 2013 CD4 385 UD 28%
July 2013 CD4 CD4 636 UD 25%
Oct 2013 CD4 588 UD 39%

Offline northernguy

  • Member
  • Posts: 1,347
Re: Viral Load Going Up?
« Reply #5 on: August 25, 2010, 03:53:45 PM »
Thanks for the words of encouragement guys.  I'd forgotten that 400 used to be considered undetectable.  I'm hoping this is just a blip.

My adherence is good, I've only been late with one dose in 6 months (took it at 7am instead of 11 pm).  Can someone explain the resistance test to me.  The pharmacist said you had to have a consistent vl above 200 for it to be accurate, is that correct?
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Offline Fri213

  • Member
  • Posts: 32
Re: Viral Load Going Up?
« Reply #6 on: August 25, 2010, 04:32:07 PM »
My ID doc said as long as the VL stays under 500 I'm fine. It's when it goes up and keeps going up that you need to consider a regimen change.

Since I started Atripla I've been undetectable twice:
04/02/09   Start Atripla
05/12/09   CD4 314 (24%) VL 577
08/11/09   CD4 351 (22%) VL Undetectable
11/18/09   CD4 400 (27%) VL 60
02/24/10  CD4 335 (28%)  VL Undetectable
05/26/10  CD4 518 (37%) VL 207

Two weeks before I had the last set of labs drawn, I had my third and final Hep A/B vaccine and I've heard that can trigger a blip as well so I'm not worried. I've also been told blips can be attributed to mishandling by the lab.

My point is look at the trend over 2-3 labs, not just one set.

I had mine drawn today so I'll find out in two weeks where I'm at.
12/15/07   HIV -
02/13/09   HIV +
02/18/09   CD4 235 (28%) VL 21,300
03/16/09   CD4 248 (25%) VL 34,900
04/02/09   Start Atripla
05/12/09   CD4 314 (24%) VL 577
08/11/09   CD4 351 (22%) VL Undetectable
11/18/09   CD4 400 (27%) VL 60
02/24/10  CD4 335 (28%)  VL Undetectable
05/26/10  CD4 518 (37%) VL 207
08/25/10  CD4 502 (30%) VL Undetectable
11/24/10  CD4 585 (33%) VL 52
02/23/11  CD4 382 (31%) VL Undetectable

Offline Miss Philicia

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  • Posts: 23,990
  • celebrity poster, faker & poser
Re: Viral Load Going Up?
« Reply #7 on: August 25, 2010, 08:04:07 PM »
Can someone explain the resistance test to me.  The pharmacist said you had to have a consistent vl above 200 for it to be accurate, is that correct?

You mean genotype testing to detect mutations I assume.  It's usually recommended that they do this before initiating your first treatment -- did you not have this done already maybe and just not know it?  Generally your viral load must be >1000 to do this test, though I've heard of it being done between 500-1000.  I think your pharmacist is giving you incorrect information, and I'm not sure why a pharmacist is discussing testing that they don't even personally do with a patient in the first place.  This is a discussion one should have with their HIV specialist.

read more here: http://www.hopkins-aids.edu/management/laboratory_testing/resistance_testing__genotype.html?contentInstanceId=264826
"Iíve slept with enough men to know that Iím not gay"

Offline northernguy

  • Member
  • Posts: 1,347
Re: Viral Load Going Up?
« Reply #8 on: August 25, 2010, 09:02:02 PM »
Yes, it was the genotype.  I had one done which showed no resistance which is why I'm puzzled by this failure for the vl to go undetectable.  ???  I should have clarified, the pharmacist is part of the BC HIV Centre for Excellence, rather than my run of the mill drug store pharmacist.  I have a doctor's appt tomorrow, so I'll make sure to bring this all up with him.
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Offline Miss Philicia

  • Member
  • Posts: 23,990
  • celebrity poster, faker & poser
Re: Viral Load Going Up?
« Reply #9 on: August 25, 2010, 09:07:15 PM »
Yes, it was the genotype.  I had one done which showed no resistance which is why I'm puzzled by this failure for the vl to go undetectable.  ???  I should have clarified, the pharmacist is part of the BC HIV Centre for Excellence, rather than my run of the mill drug store pharmacist.  I have a doctor's appt tomorrow, so I'll make sure to bring this all up with him.

If I'm reading your siggy line correctly you've only been on treatment for six months, not eight.  Like I said earlier, I've seen it take 8 months or so in others here to reach undetectable on Atripla.  I think David_NC was like that.

Stop worrying, at least for now.
"Iíve slept with enough men to know that Iím not gay"

Offline northernguy

  • Member
  • Posts: 1,347
Re: Viral Load Going Up?
« Reply #10 on: August 25, 2010, 09:15:50 PM »
You're right its 6 months, I'm not even thinking straight today!  Doesn't help that I've got some bronchial thing going on which is giving me a fever and making me hack up phlegm.
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Online tednlou2

  • Member
  • Posts: 4,814
Re: Viral Load Going Up?
« Reply #11 on: August 26, 2010, 12:11:05 AM »
Thanks for the words of encouragement guys.  I'd forgotten that 400 used to be considered undetectable.  I'm hoping this is just a blip.

My adherence is good, I've only been late with one dose in 6 months (took it at 7am instead of 11 pm).  Can someone explain the resistance test to me.  The pharmacist said you had to have a consistent vl above 200 for it to be accurate, is that correct?

How long ago was 400 considered UD?  When I got my first labs at the HIV clinic, my vl was 400.  I remember the HIV pharmacist telling me that was "basically considered undetectable."  This was early 2009.  After joining this site and learning less than 48 was considered UD, I began wondering what she was talking about.  So, there was truth in what she said, but outdated??

 


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