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When to get labs/start new regiment

Jul 4, 2004

Help! Have been HIV+ for 14 years. On Norvir and Fortovase (7 years) which at first brought CD4 count up over 600, viral load to undetectable. Slowly results not as good. Labs Nov 2003 showed viral load >1900, CD4 590, low level resistance developing. Labs May 2004 show CD4 down to 388, viral up to >20,000 copies, low level resistance still there. Dr has me scheduled for labs in 3 months. I am of course very worried. Should I request to have labs down sooner than that as in only 6 months numbers changed drastically. I am worried what they will be by then if this trend continues. As I did respond well to PI's, do I have a good chance of this with a new protocol? Or are my odds "less" now that I'm 14 year point being positive. Are there any stats on round 2 regimens, or possible "salvage" therapy? Thank you.

Response from Dr. Holodniy

You have done remarkably well with this regimen for a very long time. You have many options, including some of the newer PIs. Use of new PIs is contingent on what PI resistance has been found to this point. Since this would be your second regimen, you are a long way from "salvage therapy". Although it is not urgent that you consider a change right now, I would be inclined to suggest a regimen change earlier to insure no further loss of CD4 cells.

<50 vs. <400?
T cell count

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