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Can't reach undetectable after 24 months

Aug 17, 2014

After 24 months on medication, I can't reach undetectable level. I've been at 120 viral load for a year now. I did start at a high of 5 million copies. I have tried multiple combinations including twice daily but this made no difference. I am now taking (truvada / prezista 800mg / norvir once a day) and I still continue at 120vl. My doctor while originally saying I would definitely reach undetectable level within 6 months, then he said 12 months and has now said it could take up to 3 years, although he seems very surprised. Is this true? I'm very worried it is taking me this long and the time frame keeps growing. I have been taking regular resistance tests but nothing is showing up.

Response from Dr. Holodniy

Your case is unusual, but not unheard of. You don't indicate what your CD4 count and percent are and what they have been doing during this time frame. Unfortunately the viral load is too low to get a resistance test, in order to see whether your virus strain has acquired resistance to any of the HIV meds you are currently on or may have received in the past. There is no correct strategy here and most times it is by trial and error. In addition to changing HIV meds, sometimes adding an additional med or two to the regimen temporarily can drive the viral load undetectable. And although not done commonly, assuming excellent adherence, sometimes getting blood levels of HIV meds while on treatment is helpful to see whether you are absorbing the meds, or if you are taking other meds that might have the potential for interacting with HIV meds, in order to see whether the levels are high enough to kill HIV.

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