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Which Viral Load Test is better to monitorize a treatment?

Jul 29, 2001

Hi! Dear Doc.Mark I am writting from Uruguay. I am 22 and have been positive for the last 5 years. Since I am on Haart my viral load has been undetectable (for almost 4 years) which means drugs are working.(Thanks God!)(Before treatment I got a 125.000 copies result) My doctor is using Amplicor Roche which measures up to 400 copies I`d like to know more accurately how many copies I have but she told me that it is the same to have 400 than 40 copies. Id like to convince her to ask it for the Nuclisens Ultrasensitive test which measures 40 copies. Do you see any benefit by using this technique instead of the other one. Which are the last international recommendations about it. I appreciate your opinion. Thanks. LEO.

Response from Dr. Holodniy

Some studies indicate that there is a higher likelihood of treatment failure when the viral load is >50 copies. Thus, some patients who are not totally suppressed (viral load < 50 copies), would fail earlier if there viral load was still detectable at 50-400 copies. On the other hand some data suggests that people who have blips (intermittent viral load >50, but < 500, with most of the viral loads < 50) over time, do not fail their treatment. I think in your case, time is on your side. If you have had viral loads that are < 400 for 4 years, with stable CD4 counts, you are almost certainly < 50 copies. The 3 major viral load tests (Roche Amplicor, OT nuclisens, Bayer quantiplex) all have viral load tests that have lower level detections in the 50 copy range. MH

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