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

Viral load down, Detectable.

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TGun:
So I've been LWHIV for last 4 years,, after starting treatment quickly acheived undetectable levels and saw viral load continuously climb after every blood draw.  Four months ago i saw a dip in viral load and still was undetectable,, ID MD said don't worry about it.  Now i just got back my next quarterly labs 10 days prior to my visit and my viral load has sunk even furthur (833-512) and now im undetectable (+20) . 

is there anyone on here with any first hand experience or knowledge as to what to expect and how to proceed.. i guess im mentally torn up over this and its agonizing to wait till next friday for some qualified answers..  any help is appreciated.

leatherman:
are you talking about your cd4 count? "Undetectable" (i.e. <20) or a viral load <200 means successful treatment

if you're talking about your cd4 count, then there isn't anything to worry about. the "normal" range of cd4s is anywhere from 400-1200. There is nothing to do to increase cd4s besides staying adherent to meds (so hiv doesn't kill those tcells) along with good exercise, good nutrition, less stress, no smoking, etc.

cd4s can change by 100 pts in a day, so are highly variable between each test.  Also the cd4 count is an absolute quantity number and not a measure of the strength/effectiveness of your immune system. The idea is that more cd4s is better although some people with low cd4s experience little illness while some people are sick with high counts. Unfortunately there is no way to measure the quality of someone's immune system.

For PLWH that just means that the cd4 count means little as long as it's >200 (less than 200 has been shown to make people exceptionally susceptible to having an opportunistic disease). The number to really watch is the VL. If it's in the "undetectable range" then HIV is suppressed and your body is basically running the way it would without HIV.

TGun:
leatherman,,, thanks for your reply,,, i was actualy talking about both numbers.  CD4 keeps dropping while predictably always increased during every visit, and Viral Load was always undetectable,, but now is detectable.

i go to quest labs, and what is weird on their report is how it reads.. it says "Hiv <20 detected"   and its in a re box,, although usually its a great box and says not detected.  so whats bizzare is that theres no acutual number,,, the way i read it its either more or less than 20.. and also they typing isn't any diffrent, just the color of the box,, its usually green and now its red....so im reading it to be detected <20....i know this may sound confusing,, sorry

Jim Allen:
So HIV was detected but below the threshold that the test could provide an accurate count. The result you mention means your viral load is still "undetectable" (fully suppressed) in any way that matters so treatment & passing the virus on.

If it was my labs only if the VL unexpectedly reached mid to high hundreds might I raise an eyebrow.

Jim Allen:
P.s I'll post references after finishing work

EDIT - updated below with a post & links I used for a similar question.


--- Quote ---anything under 200 copies is UD in terms of forward transmission. https://forums.poz.com/index.php?topic=71848.0

Minor blips can happen for various reasons, there is strong evidence that as ART takes care of the active viral load some transient blips are nothing more than the detection of the low-level release of virus from existing reservoirs, including defective copies and that those who blip more often tend to have larger HIV reservoirs and hence it's not a concern for with the treatment etc.

See link for "What’s All This Fuss I Hear About Viral “Blips”?

Treatment wise, it's still generally accepted anything under 50 copies is fully suppressed/UD although blips past that are not really a concern either if it's a once-off or remains at a controlled low level.

Blips
http://i-base.info/guides/changing/viral-load-blips

Viral Blips Don't Raise the Risk of HIV Treatment Failure
https://www.poz.com/article/viral-blips-raise-risk-hiv-treatment-failure

http://www.aidsmap.com/Spanish-study-gives-reassurance-small-HIV-blips-do-not-predict-treatment-failure/page/3085173/

What’s All This Fuss I Hear About Viral “Blips”?
https://academic.oup.com/cid/article/70/12/2710/5573119

TaSP U=U
https://forums.poz.com/index.php?topic=71864.0
(*undetectable viral load defined as less than 200 copies/milliliter)

Q&A on persistent low-level viremia.
https://www.healio.com/infectious-disease/hiv-aids/news/online/%7B8373ca63-674d-4015-ac35-f4da653c7415%7D/qa-understanding-persistent-low-level-viremia-in-people-with-hiv


--- End quote ---

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