Dear Doctor:

I was diagnosed with Aids (CD4's 170/18 & VL 149,000) in January of this year. Began Trizivir on March 23. ARV treatment was delayed two months because of Prednisone therapy for low platelets (13,000), which are now over 200,000. Was undetectable less than six weeks after starting ARV's. In July, I suffered a heart attack and was hospitalized in CCU for a week. Missed three doses of Trizivir. Ten days after hospitalization, blood tests came back as follows: CD4's 466/24 and VL 965.

Saw my HIV specialist this week and requested a follow-up viral load. I'm afraid of resistance. Doctor denied my request saying it was better to wait for a while. He feels that detectable virus could be result of missed meds, an undiagnosed infection or cold while hospitalized, or IV's of blood thinners and nitro given while receiving heart attack treatment. As mentioned above, I'm afraid of the possibility of resistance and wonder if my doctor is allowing valuable time to pass by. What are your thoughts, suggestions or opinions and what would you recommend for a patient with a similar background? I appreciate your response.

I agree with your doctor. You have had a great response thus far. You have also had a few bodily stressors that could affect the viral load in the short term. I would not react to that viral load unless a followup viral load showed a significant trend upward. It is likely the next one will be less. MH