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VL fell and again rose

Jun 1, 2008

Hi i was diagnosed positive 1 year back, my CD4 count was 199 with a VL of 135000. I was put on a combination of Lamivudine 150mg, Stavudine 40 mg twice daily and saquinivir myslate 500 mg once. After 6 months of treatment my CD4 count was 224 and VL at 6500. However last week i got my test results as CD4 count 389 and VL at 31000. What could be the reason of increase in VL? I have been taking my meds very regularly.

Response from Dr. Holodniy

Your viral load should have become undetectable by 6 months. One thing is you are not receiving the correct dose of the saquinavir. You should be getting two 500mg caps along with 100mg of ritonavir two times a day. This may be contributing to the problem. The first thing is to get a resistance test and see if your virus has developed resistance to any of the meds you are taking. Then you need to either increase the saquinavir dose, or change the meds you are currently taking, depending on what the resistance test shows.

drop in cd4 count and %

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