Blips

[MadDog125]

I was diagnosed 28DEC17 started drugs 06JAN18.  Since then I saw the typical rapid drop in viral count.  Yet for the first time I saw an increase.  30 increased to 61.  Apparently "blips" are common In the first year or two.  I'm wondering how common and how much of an increase?  Some of what I've read suggests increases under 100 are inconsequential.  Has anyone seen an increase of a thousand?

[Jim Allen]

If you ask me well, 61 is not really even a blip, its single snapshot moments and if you took measurements over a few days you would have some variance

True, vial load blips can happen and, in the first year of treatment anecdotally it seems to be more common. Blips can also stem from things like being ill, lab error and a number of other reasons, however as long as you are adherent to the meds, you should be fine.

Clinically speaking under 50 is undetectable even though lots of labs can be more accurate than that and, virological failure is mostly seen as a failure to sustain a person's viral load to less than 200 copies, also on the more recent studies into transmission I believe the UD threshold for transmission was set at the higher virological failure threshold, so anything under 200 was considered UD.

Has anyone seen an increase of a thousand?

Yes, but that's normally not a blip. VL of 1000's is getting into treatment treatment failure. Main cause usually is poor adherence to ART. So take your meds consistently as directed and, this should not be an issue.

Jim

Blips:
http://i-base.info/guides/changing/viral-load-blips
http://www.aidsmap.com/Viral-blips/page/1729801
https://www.poz.com/article/treatment-viral-blips

Virologic failure
https://aidsinfo.nih.gov/understanding-hiv-aids/glossary/879/virologic-failure
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839839/
 

[CaveyUK]

It's a micro-blip (tm) and wouldn't worry unduly about it. As said, it can happen for a variety of reasons and I have no doubt that your next set of bloods will be back down to UD.

[Jim Allen]

It's a micro-blip (tm)

https://www.gov.uk/government/organisations/intellectual-property-office

[CaveyUK]

I really should, then I can 'lawyer-up' when it catches on in the medical profession

[leatherman]

I really should, then I can 'lawyer-up' when it catches on in the medical profession

can I get a portion of the proceeds for my part in the original discussion?  

[CaveyUK]

can I get a portion of the proceeds for my part in the original discussion?  

of course! And when I make the fortune from the 'micro-blip' spin-off mugs, t-shirts and cookware then your hardest decision will be whether to have a red, or blue Ferrari

I'm already 'working' on the follow up....."nano-blip" but it needs some refining....

[MadDog125]

Capitalist at heart😊
Hit while the irons hot. 

[MadDog125]

Just had another round of bloodwork on the third.  Results posted this morning.  Well still detectable nine months in, cd4 bumped up a whopping two points.  VL35 CD4 300,  from VL61 CD4 298,
I get it that's supposed to be good news.  Most are undetectable in 28 in weeks.
The major concern for me is expect the doc to recommend adding a protease inhibitor.   Anyone on one already?  Experianced side effects?  The idea of yellow eyes seems particularly fun.

[Jim Allen]

VL35

Congratulations your UD 

Jim

[MadDog125]

Scale bottoms at 20 with quest diagnostics.  I came home to results and a message from the doc.   He wants to see me again.  I'm not keen on adding a drug.

[Jim Allen]

Scale can go even lower, that depends the tests limit.
Within 9 months you have reached UD as in less than 50 copies, fantastic.

By all means keep working with your doctor but in terms of treatment clinically speaking under 50 is undetectable (WHO) even though lots of labs can be more accurate than that like your doc's lab detecting until 20. So your UD.

What if your lab in 5 or 10 years decides to splash out a new device that lets say detects down to 1 copy, will you be chasing that number?

Virological failure is mostly seen as a failure to sustain a person's viral load to less than 200 copies, this is also the limit used in the U=U statements.  Congrats your virus is suppressed.  9 months to get there is nothing new, just keep taking your meds as clearly they are working would be my advice

Jim

https://www.poz.com/article/treatment-viral-blips

[MadDog125]

I don't know really.  For me I'm following the docs lead.  I just know he's is talking about adding a PI.  I would literally nuke my system if that would help.  It's the age old arms race.  The fewer the better, zero isn't likely to ever hapen, the Berlin patient was a fluke, not to mention every lab national or private is focused on either a vaccine or improving supression.  It's like triage, for a pandemic figure out how to stop the spread. 

[Jim Allen]

I get it, we just look at this different in my view I'm UD by all treatment standards. If its 5 copies or 35 copies no real difference in the outcomes, no evidence to support otherwise in fact plenty to support its fine and so I would personally not be adding another drug when I'm on target.

Jim

[bocker3]

Just had another round of bloodwork on the third.  Results posted this morning.  Well still detectable nine months in, cd4 bumped up a whopping two points.  VL35 CD4 300,  from VL61 CD4 298,
I get it that's supposed to be good news.  Most are undetectable in 28 in weeks.
The major concern for me is expect the doc to recommend adding a protease inhibitor.   Anyone on one already?  Experianced side effects?  The idea of yellow eyes seems particularly fun.

First -- I do agree with the others on here, you are successfully suppressing your virus by all clinical standards that I am aware of.  I also understand your desire to get a lab report that says "UD".  I don't quite get your doctor's push to add a PI to this minuscule VL however. 

I (and others) have printed out threads from this forum to take to discussions with my doctor.  It helps ensure that I remember, and he sees, my questions/concerns/etc in a fuller context.  It helps him to also either reconsider or explain his reasoning differently.

At any rate, you asked a question above so I will answer.

I am on Sustiva/Descovy as well as boosted Reyetaz.  Why?  my virus came to me with resistance to almost every nuke out there.  Since 2 nukes make up the backbone of just about all the regimens out there (certainly ALL of them when I started this journey in 2005).  The PI was added so that I wouldn't be, essentially, on a 2 drug regimen.
I have experienced no real side effects from taking all these meds (5, counting the Norvir) and I have NEVER had yellow eyes -- though my bilirubin is often above the reference range. 

So -- my advice, listen to your doctor, but make sure he/she listens to you too.  If you are reluctant to take another med, make sure you two discuss that and come to a decision together.  This should be a partnership!!!

Good luck
Mike