Meds, Mind, Body & Benefits > Questions About Treatment & Side Effects

My first viral load blip in 4 years.

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leatherman:

--- Quote from: Miss Philicia on November 26, 2012, 07:23:55 PM ---those numbers still really don't mean anything as far as I'm concerned.

--- End quote ---
^ this J220

in the grand scheme of things, about 5 or 6 yrs ago 400-500 was undetectable. Counts under 100 certainly should not be counted as blips.  ;) LOL


--- Quote from: J220 on November 26, 2012, 03:09:52 PM ---I know I can count on having many blips down the line

--- End quote ---
that is not really true. While you might see small jumps (<300) in your counts - as HIV is never 100% eradicated - blips (which are usually > 1000) are usually quite rare. If you stay adherent to your medication so that no resistance is allowed to happen, blips should never occur as the virus is always kept in check


--- Quote from: J220 on November 26, 2012, 03:09:52 PM ---my doctor is stumped, and does not know what to make of it.

He says this is not an indication of treatment failure yet, and is not really concerned, and just wants to see me in four months.

--- End quote ---
think back real hard without putting your spin on things. Was your doctor truly "stumped" or was he "not really concerned"? As your "blipette" wasn't even approaching 1000, I'd bet money that your doctor was not really concerned. If he doesn't want you back for blood work for another 1/3 of a year, he can't be all that concerned. ;)

Of course, any smallish rise in CD4 count is apt to make a doctor question your adherence. Less than 25% of all HIV positive people in America remain in proper therapy and undetectable - so it's pretty common for doctors to be looking for the slightest hint of patient adherence failure.

Ann:

--- Quote from: leatherman on November 26, 2012, 08:18:05 PM ---
Of course, any smallish rise in CD4 count is apt to make a doctor question your adherence. Less than 25% of all HIV positive people in America remain in proper therapy and undetectable - so it's pretty common for doctors to be looking for the slightest hint of patient adherence failure.


--- End quote ---

For the benefit of the newbies, Mike meant to say "Of course, any smallish rise in VIRAL LOAD is apt to make a doctor question your adherence."



Sometime in this past year, my doctor and I had a long talk about a study he is currently conducting. (He's an hiv pharmacologist who does a lot of research in conjunction with the University of Liverpool and also is also responsible for the http://www.hiv-druginteractions.org/ website.)

Basically, the study is looking at the CNS fluid of people who have repeated, low level VL blips. The theory behind the study is that if the meds you're taking aren't crossing the blood/brain barrier in sufficient quantities (or at all), this means there is constant viral replication going on in this particular hiv reservoir. (Keep in mind there are other reservoirs where the VL is much more difficult to measure.)

The theory goes on to speculate that occasionally, the virus is "spilling over" from the reservoir (in this case the brain and CNS fluid) into the blood stream and that is what is causing the detectable "blips".

When this "spill over" occurs, the meds readily available in the blood stream quickly bring the VL back down to UD.

There are details of this study somewhere online, but I don't seem to have bookmarked the page. If anyone is interested (it's just study criteria and protocol, no results yet) I'll try to dig it out.

I only know about this study because my partner took part in it this spring. I spoke in depth about it with our doctor because the language of the study protocol worried me (it talked about "persistent viral load") and I wanted to know what the hell was going on - if he had a persistent VL, why weren't they changing his meds instead of using him as a guinea pig? Turns out they were talking about blips, not a constant detectable VL. Whew! ;D

leatherman:
ick! HIV spilling over out of your brain.
so my blips are just my brain barfing up virus.  :P


--- Quote from: Ann on November 27, 2012, 07:14:51 AM ---For the benefit of the newbies, Mike meant to say "Of course, any smallish rise in VIRAL LOAD is apt to make a doctor question your adherence."

--- End quote ---
oops! Thanks for the catch! Obviously my fingers weren't listening to what my brain was saying as I was typing

and another oops too. It's 28% that remain in care and undetectable. 28%, 25% ;D I was still close because 28% is closer to a quarter than a third. Either way it's very troubling for treatment, for transmission suppression, for future funding, for people's health - and no wonder doctors may be wary of any blips or blipettes ;)

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