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

VL goes up and down....GRRRRR!

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Hi guys! I have found difficulties with my medicines again...I started to take Kaletra-Combivir in Octobet 2005. Then my vl was 290.000 and CD4 was 120. I had PcP in September 2005 and then my hiv was diagnosed.
It took about 6 months to make my VL undetectable-In January -March 2006 my VL was between 50-100 but still detectable.
Then March till September my VL was undetectable, but now my VL jumped to 62!!! My doctor worried what is wrong-I have taken my medicines regularly and in time!
Question is: Why my VL don`t wont to be down? My doc thought that i have some absorbing problems with (old) Kaletra and now I take new Kaletra tablets that are said to be more effective than older ones and with fewer side effects.
Is here any positive people those VL won`t go undetectable? I wonder if I`m resistant already to my meds...
This makes me crazy-my VL will make me mad when it plays like that....... >:(

Hi Harry,
Get a drug resistance test, tell him you want one.

Other than that, more knowledgeable ppl have to answer your question.

Best of luck

well a viral load of 67 is really nothing to worry about but if you are really that concerned , i suggest you have your doctor perform a GENOTYPE,then you will know exactly which drugs that you have developed a resistance to and which drugs actually will still work for you!!

Hi harry,

As your VL was undetectable on a six months period, perhaps it is just a blip.  Did your doctor order a new test to verify ?

A viral load of 62 is nothing to worry about right now. I am not sure if you are aware but undetectable doesn't mean = zero. The viral load test is sensitive but not absolute. A more expensive and accurate test revealed that the viral load goes down to an AVERAGE of 20 (depending on who you are it can be higher or lower than that). The viral load can also do what they call BLIP. A BLIP is where the viral load goes up to sometimes a hundred or so and goes down to undetectable. A study has revealed that this BLIPPING is common and occurs in almost all of the people who are undetectable and no reason has been found for it related to personal health or complance. Its a mere fluctuation around a new set-point and it can go up and down. The study I mentioned took viral load samples every three days and they found BLIPS were fairly common and not repeated by all testing stations. In fact only one BLIP was confirmed by two testing stations. What they thought is that a BLIP can be caught in a viral load test and you can go months without ever finding one or you could get one a few times. It depends on what the set point is and how close to 50 it is. If you have an average nearer 50 you are going to fluctuate around that mean and therefore more likely to see a BLIP. I spoke to the author of the study and he confirmed his conclusion that this is NOT related to resistance or an increased chance of resistance. If you send me a PM with your e-mail address, I'll send you a copy.

The key is to watch the viral load and see what it does next time. Next time if it goes up to a few hundred or a few thousand then yes, get a genotype/phenotype test. However, 67 is no high enough to call out the army. Viral load tests are a static look at the viral replication and the whole picture is revealed over time and not by one snap-shot. An increasing viral load is indicative of resistance.

I hope that helps...



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