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when do i start getting worried about non-response ? or should I just be patient?

Sep 22, 2013


Here are my numbers:

7/10/13: HIV+ OraQuick at home 7/11/13: CD4 <20 , VL 298,000 ... started Bactrim/Azithro 7/26/13: started stribild 8/13/13: CD4 64 , VL 1194 (18 days) 9/11/13: CD4 87 , VL 511 (48 days)

I've taken all my pills in the evening with food every day, as instructed. I was satisfied with my first month's result and logarithmic drop, but now my VL's response has been blunted! When do I have to start worrying about resistance?

The reason I'm worried is because the first genotype test didn't get drawn properly and so I had to repeat it. I'm still waiting for that result.

I highly doubt I got virus resistant to integrase inhibitors (I probably caught HIV in 2005-6, way before integrase inhibitors were invented) but now I am concerned.

Compliance is not an issue with me, though I did have a cellulitis at the time the labs were drawn... could this raise the VL?

When do you start advising patients to change treatment options?


Response from Dr. Holodniy

I think you have had a fabulous response thus far and are still in very good shape with this regimen. I am not concerned. you need to give it another 1-3 months. If the viral load is stalled then, a regimen modification might be in order.

CD4 counts and a concerning scenario

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