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vl progress..
Sep 27, 1999

Dr.Mark,

Thanks for your superb touch and expertise...I started therapy April 9, '99.. d4t/aba/nvp...253cd/19000vl..at four weeks I was down to 330vl..my 16th week results were 106vl..my NP had asked about missed doses. I have not missed a single dose. Is this a blip? Am I resistant perhaps? I had a cd4 taken today and a new vl in November. Are some people slow to reach undetectable? Switch to Sustiva? Switch two drugs? I am disappointed. What's going on? I thought this was a potent combo...

Response from Dr. Holodniy

Some studies (including those with nevirapine) have shown that it can take as long as 6 months to get to <50/ml. You have had the predictable response to <500 within 4-8 weeks. That last bit to <50 can take much longer. Studies have shown that if you don't get there by 6 months, it is unlikely that you will. If the November number is not <50, it's time to modify.

MH



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