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Viral Load Increase
Sep 3, 2006

My partner was diagnosed HIV positive in 2000, 3 months after initial infection. At that time he was started on a regimen of Sustiva and Combivir. Within 3 months, his viral load was reduced to <50 copies and has remained there until his most recent laboratory visit this month, at which time his viral load was tested to be 235 copies, and a CD count of 575. Does the presence of detectable virus indicate impending failure of the drug combination? And if the viral load continues to rise, would HIV genotyping be a viable option prior to starting a new drug combination?

Response from Dr. Holodniy

Unlikely, but possible, this represents failure of the regimen. It is more likely a reflection of assay variability. I would predict that on the next test it will likely be back to undetectable. However, if it continues to rise, then yes, a genotype test would be in order. Most commercial labs require a viral load of > 1,000 to perform such a test.



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