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Vireal Load not undetectable after 2+ yrs of treatment

Nov 5, 2011

My viral load has been about 100, and intermittently undetectable (but not consistently) since I started Atripla in Jan 2009. My tolerance of the med is fine. When I started treatment, my VL was 65,000 and my tcells were 450. My last labs showed my VL went up to 584, although I had a cold at that time. Does the increased VL indicate the beginning of treatment failure? My doctor seemed to be not too concerned about it and said we'll see what the next labs show in 3 months. I, on the other hand, am concerned that my VL has not been consistently undetectable since I started treatment over 2 yrs ago. I've not missed a dose, but have been several hours late about a 1/2 dozen times since I started treatment. What are your thoughts on all this? Thank you.

Response from Dr. Holodniy

I understand your concern, but also agree with your doctor's plan. Unfortunately your viral load is still too low to get a resistance test to know whether the virus has become resistant to any of the drugs in atripla. I think if the viral load is 500 or higher at your next visit, then I would suggest a resistance test if the viral load is > 1000 and a change in your treatment regimen.

Comparision of CD4 drops after discontinuing HAART
inmune reconstitution syndrome

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