Viral load keeps going up

[poz92116]

 so I was undetectable, but my most recent results came back with a viral load of 93. I take my pill every day, and I've never missed a dose, but I'm wondering how sensitive it is to what time you take the pill ?  I take triumeq. During the week I wake up at around six for work so I usually take my pill around 7 AM, but on the weekends I sleep in a lot so sometimes I don't take my pill till 10-11am...  Do you think that's a problem ? Could that be the cause of my viral load increase?

[Jim Allen]

Hi

As i mentioned before I think it's just a blip and it can happen.

http://forums.poz.com/index.php?topic=62313.0

Yeah sounds like it just a blip, this can happen and you have only been on the meds for a few months. As long as your taking you meds correctly and consistently don't worry about it too much, just keep on taking your meds. ;-)

As for the timing I take my meds within a 2 hours window each day, with the goal of course of taking my meds at the same time. Generally speaking for best effect, the meds need to be taken as instructed and ideally at the same time. Within a few hours range. This allows the drugs to remain at the correct levels in your system.

It's best if you don't miss any doses and of course the goal should be 100% adherence. If the morning routine is not working for you, you could consider changing the timing of your meds to a time that would be more convenient.

Jim 

[Wade]

I had a blip my last labs , as Jim said it happens.
I took my meds at bed time for many years until a recent med change.
Well sometimes I went to be at 9 , some times midnight . It was never a problem.
Life happens.. we do the best we can.

Best, Wade

[poz92116]

Most recent was 78, last one 6 months ago was 22, before that was undetectable, before that was 93... before that was undetectable.
Could this mean my Triumeq isn't doing a good enough job? My cd4 count was 766 6 months ago and is 785 now.

[Jim Allen]

What did your doctor say? Are you adherent?

Look it's only 2 tiny "blips" only just above clinical UD , so unless your doctor is concerned you should not be either at this stage. First few months on treatment blipping can happen, it can happen at any stage, can happen if you are sick like the flu ect, no reason to panic or worry.

Just keep doing what you can, take the meds daily and see what the next results are like. Its all about the trend not the snapshot result, if and that is a if the VL does increase they can check for resistance and switch your treatment if needed but don't worry or think that far ahead.

Relax

Jim

[Jim Allen]

I merged your two threads on this FYI.

As for the total cd4 count it will always vary between tests, if I tested in the AM and again in the PM the results would be different. Means nothing as long as it's in normal/average range I would not worry about it at all, or know at least that worrying about pointless to a degree, as there is nothing you can do to change it.

Jim

[poz92116]

I've been on Triumeq for 2 years and have never missed a pill.
I just worry because I've had more detectable than undetectable results in the 2 years I've been poz. I don't know why my Triumeq isn't keeping me below 50.

[Jim Allen]

You had a few blips, personally I would not be worried.

Have you talked to your doctor about the results? If so what did they think or say ?

If you really are concerned and the doc agrees you could test and switch treatment but that is really up to you and your doctor. It's not unheard of that some people blip for no reason and after switching have continued surpression. 

Jim

[Mightysure]

I would really rely on my doc on this. Your increases aren't ideal, but it may not be resistance either. It could be interactions with food or other meds you're taking, that's why I say go to your doctor bc she or he would be more equipped to find a cause, if it's a concern.
Do you know what your resistance results were?

[poz92116]

Well I went to my doctor yesterday and she didn't seem to really care.
She basically accused me of being flakey about taking my meds, which is not true as I have never missed a pill in 2 years.
Sigh. Doesn't seem like anyone cares anymore about people.

[Jim Allen]

Hi

To be honest it does not sound like she does not care about you, simply that the blip is irrelevant, that said you were there I was not.

If it is really bothering and you can't get past this than perhaps you can see a different doctor, if anything it should at least give you some reassurance and peace of mind. Peace of mind is priceless. 

Jim

[harleymc]

I had a doctor who told me, without evidence, that I was being non-adherent.
I switched medical practices.

You don't need that from some one who is supposed to have your wellbeing as their professional practice. If you feel motivated I'd consider lodging a complaint to your local medical board.

[Mightysure]

Her method may have been off, but I don't think she doesn't care about you. It's just not something that is alarming to her.
I know the message is "UD=Untransmittable" and the goal is to get to UD, but you have to keep in mind that we're all different, we metabolize drugs differently, and we have different variations of the virus. It may not be a big issue. The only reason why you're getting those number sis because the sensitivity of these tests has dramatically improved. The first generation tests had a cut off of 500, do you wouldn't have known anything then.

If it's causing anxiety, maybe suggest a change in meds? I'd suggest Genvoya, if that's available in your country. Only thing, you have to take it with food.

I honestly think your doctor isn't worried because it's not an alarming thing. Do you know what your resistance tests were? That will determine your treatment options.