Need for resistance testing?
Nov 22, 1999
Hi. Thanks again for your invaluable knowledge and support. Here's my story:
*Tested positive 2/99. Had VL of 51,000 and cd4 of 182.
%cd4 pos. 13.0
*4/99 VL = 637, cd4 = 210 and % = 14.0
*6/99 VL = 110 cd4 = 224, and % = 14.0
*8/99 VL = undetect., cd4 224 and % = 16.
*11/99 VL = 154, cd4 221, and % = ?
I had a 3-day flu with diarrhea shortly before my 11/99 testing. My doctor wants to retest in 1 month. My questions are the following:
1)Should I be looking for an alternate treatment?
2)Is there anything I can do to increase my cd4 counts?
3)Would you recommend resistance testing at this point? If so, specifically what kind.
4)Given these numbers, how long would you guess I have been positive?
Response from Dr. Holodniy
1. I would wait for the repeat VL. If it is < 50, I would stay the course. If it has increased greatly, time to change.
2. This is a tough one. You should have seen a bump with the potent regimen you are on. Sometimes we have seen delayed (6 months or more to see the increase) responses. IL-2 could be tried, but your CD4 count is a little low to see large responses.
3. Resistance testing requires VL of > 500-1000/ml for detection.
4. I couldn't pin it down, but I would guess at least a few years.
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