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Viral Load Blips and Med Change
Jan 29, 2005

Dear Dr.:

I have been on Viramune, Viread, and Epivir for the past two years or so. I have maintained an undetectable viral load and steady CD4 count (350-450, 22-25%), except for three or four small blips in the viral load. One VL was 100, the following month 255, then undetectable three and six months after that. Three months after these undetectable readings, another blip of 67. At first, the doctor didn't see cause for concern or change of medication, but upon discussing it, she said that I may have some resistant virus that is breaking through periodically. She suggested changing my Epivir to Emtriva, since that supposedly is better able to keep the virus down. Do you think I should make this change at this point, or should I wait until I've had more and higher blips, even perhaps until I have a VL that can be tested for resistance? Thank you.

Response from Dr. Holodniy

This just came into my mailbox. Either strategy would be acceptable. Probably easier to switch to truvada (which contains viread and emtriva in one pill) which is given once daily.



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