Nov 26, 2017
I have been undetectable for 10 years taking Truvada and Nevirapine. For the sake of comfort (1 tablet daily) my doctor switched to Eviplera (emtricitabine + rilpivirine + tenofovir). Suddenly my viral load rose to 39 but returned to undetectable afterwards. In the last two blood tests my viral load was 129 and 139. My doctor changed my medications to Tivicay + Truvada (emtricitabine and tenofovir disoproxil fumarate). I am not yet aware of the results of this medication (I have been taking these medicines for 3 weeks). 100% adhesion. What could have happened? CD4 = 834, 32%. Best regards from Lisbon, Portugal.
Response from Dr. Holodniy
It is unlikely that the new HIV med (Eviplera) was not effective after you first switch, given your HIV viral loads on your original regimen had remained undetectable. We certainly can see this kind of HIV viral load blipping and become concerned when the viral load remains or continues to increase above 200 copies/mL. You don't indicate whether you are taking any other medications, but sometimes there can be an interaction between your HIV meds and other meds causing the levels of the HIV meds to decrease and therefore not be 100% active. In general with these blips, the viral load returns to undetectable levels like it did the first time. I can certainly understand why your doctor switched you again, given that two viral load results in a row were still detectable. I predict your viral load will again be undetectable after this new switch, and given your excellent CD4 count and percent in the normal range.
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