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drug holiday but still undetectable

Aug 23, 2009

Hello. After 3 weeks OFF medication (due to travel), my viral load remained undetectable. In the past, if I've gone off meds, the VL always rises quickly. Not this time, though. Is this unusual? My doctor said it was "highly unusual" but didn't seem particularly interested in investigating further. Out of curiosity, if you had a patient with an undetectable VL after 3 weeks without meds, what would you think or suggest? (I went back on meds a couple days after getting the lab work done -- but before I knew the results) Should I try going off them again to see what happens? Thanks so much.

Response from Dr. Holodniy

Your doctor is correct, that would be highly unusual, but not unreported. Part of deciding what one would do if confronted with these findings depends on what the CD4 count was when you started treatment and where it was when you stopped. If you started treatment when your CD4 counts were high (say > 400-500) and have remained > 500, I might consider watching someone carefully off treatment for a while to see where the numbers went. On the other hand, if the CD4 counts were low prior to treatment and remained below 400-500 while on treatment, I would recommend remaining on HIV treatment.

CD4 and PCR shipping sampels
immunohistochemical study

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