As at 15 March 2009 my CD4 was 24 and my viral load more than 500,000.I have been adherently on Lamzid and Efavirens between 23 March 2009 and 15 June when my CD4 was 169 and viral load 184000. I changed to avoid lipodystrophy to Truvada and Efavirens from 15 July 2009 to date. The last bloods were CD4 287 and viral load 105000. A helpline adviser has told me I should have been undetectible by now. I never missed a dose but have been taking the meds between 20h30pm and 23h00pm every day.On one occasion at 02h30 am. Is there any cause for concern and what would you recommend?

Hello,

So far everything is going in the right direction. Your CD4 count has increased dramatically from 24 to 169 to 287 over the past six months. This shows an excellent degree of immune system recovery. So you're doing quite well immunologically. Your HIV plasma viral loads have decreased from greater than 500,000 to 184,000 to 105,000 over the same period of time. This shows the level of HIV replication is decreasing. It is true our target is to get the viral load as low as possible (hopefully "undetectable") as quickly as possible. While we would have liked to have seen a more rapid decline in your viral load, the fact that you are steadily decreasing is good news. If your viral load does not continue to decrease with each subsequent determination, I would suggest getting an HIV resistance test to ascertain if you may have developed resistance to one or more components in your antiretroviral drug regimen. If so, a switch in therapy would be warranted.

Good luck.

Dr. Bob