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not able to get undetectable
May 11, 2008

i was diagnosed with AIDS three years ago and promptly started a regiment of Kaletra and Truvada (my cd4 was 47 and my vl was 667,000). During the next 1 1/2 yrs. my cd4 rose to 460 but i was only undetectable once. This past Dec my vl crept up to 1000 so a genotype was done and showed only a minor mutation but nothing that would cause resisitance. Still my doc switched me to prezizta and truvada 5 mos ago. My cd4 went up to 560 and my v.l went done to 70 until my last two blood tests done 6 wks ago and 2 weeks ago..they read a vl of 200 and most recently 240. I am very very concerned and the doc can't seem to give me a reason why. i am virtually perfect with adherence to my meds. Is it time to switch to a regiment from a different class?

Response from Dr. Holodniy

I understand your concern. The good news is you have overall had a great response. Despite that, you appear to have a persistently low detectable viral load. Unfortunately, the viral load is too low to get another genotype. It is possible that this is related to assay variability, but given this is not blipping (between undetectable and low detectable), it is probably real. I don't think you need to switch all your meds. It may be useful to add an additional agent at this point to drive the viral load down to undetectable.



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