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Nov 10, 2013

Dear Dr. Holodniy,

Thank you for your help. I was wondering how quickly viral load levels would increase if someone was to go off meds for like a month or so. Right now I'm taking Truvada + Isentress and have had a good response, but the dizziness spells and frequent migraines from the Isentress are REALLY bad, so I talked to my doc about switching to Tivicay.

2/12/13 CD4: 370; CD4%: 29 VL: 143,000 3/20/13 CD4: 300; CD4%: 28; VL: 158,000 (Started Truvada + Isentress) 4/25/13 CD4: 330; CD4%: 28; VL: 9,361 8/1/13 CD4: 449; CD4%: 32; VL: 67 11/1/13 CD4: 467; CD4%: 33; VL: UD

I know it's not a good idea to go on a "medication vacation" so to speak because of running the risk of resistance issues, but these side effects made me consider it. It's probably difficult to say due to individual variation, but would going off the meds for a month could I expect my viral load to soar to my initial viral load levels?

Response from Dr. Holodniy

Yes, your viral load results will likely increase after a month of HIV treatment. Everyone is different, so it is difficult to predict how high the viral load might go. The best time to switch is when the viral load is undetectable.

slow decline of viral load-should I worry?
CD4 count dropping with stable %ratio

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