Likely overreacting - do check adherence and possible interactions (cations on an empty stomach with meds?) but levels below 200 are generally not something to worry much about.
Hi Samuel- a viral load of 85 copies is, in my opinion, nothing to worry about. The threshold to start thinking is over 200 copies. And realistically you won't be able to amplify any resistance on a genosure at 85 copies as it needs 400 copies. Remember resistance is a breakthrough occurrence due to suboptimal drug levels on virus, thus the dominant virus has the mutated species. At 85 copies it's hard to really quantify since this can also be what is called a "blip" which are viral loads under 200 copies and then go back to undetectable.
if you ran a genosure archive I would be really cautious with how you interpret that test as it is specifically for people who are NOT failing to see in the pro viral DNA what mitigations there are in general, not just in that moment of failure.first thing I would do is make sure they are not taking any cations like mag or iron, like Maalox or tums. There actually is a small drug interaction and it should be kept in the forefront to remind patients of this (package insert has all the time requirements or food requirements) . Second, I would do counseling on adherence, which I think many people have gotten away from because they see the undetectable VL and think that is enough, but counseling on adherence, dosing etc is really good to do. 3rd just recheck the viral load. No need to jump to an expensive test when it's not warranted.