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How important is the

Oct 7, 1998

I have been HIV+ for approximately 4 years. I have been taking zerit, epivir and viramune for 1.5 years. These are the only medicines I've ever taken for HIV. Presently I have the "400" viral load test done every 2 months. Under this test, my VL is non-det. and my t-cells have gone from 550 to 925. I would have to pay for the more senstitive test. Is it worth it for me to do that at this point?

Response from Dr. Holodniy

Probably not. Trends over time are very important. If in fact your viral load has been < 400 for a 1 1/2 years and your CD4 count has been consistently high without decline, it probably will not add much. Newer information suggests that the likelihood of drug failure is much less when the viral load copy is <50. However, in my own practice, ultrasensitive assays have presented treatment dilemmas. Many patients who were undetectable at 400 or 500, now have "detectable" viral loads of 71, 124, 210, etc. Some patients have limited options left and I am reluctant to change their regimen based on such low, but detectable numbers. I have had many patients do very well over the last 3 years without the benefit of the ultrasensitive test.

MH



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