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couple of questions on VL, virus resistance etc...
May 28, 1999

Dear doctor,

I have just two questions for right now.. the first is on viral load. What ranges are considered good, average, bad and very bad? I am sure it probably has to do with your viral load and CD4 count. My partner is HIV+ his last viral load cound was at 16000 and cd4 count at 200 (pretty low)is that good or bad? If the next viral load test results in an increase or decrease, how much of an + or - must there be for there to be a signifigance in viral load to think about changing drug regimens?

My second questions has to do with adherence to drug therapies. My partner adheres to the therapy for the most part but sometimes he will miss a dose. He never misses a whole day but just a dose within that day every once in a while. I guess my question is how long does the drug coctail stay in the body (half life) and if you miss a dose here and there, but not often, what is the likelyhood that the virus will mutate and thus rendering the drug regimin that he is currently on ineffective?. My partner is on Combivir 2X / day and Viracept 3X / day.

Being that my partner is on Combivir (which is AZT and 3TC) and Viracept does that mean he is on a HAART drug therapy?

Also I am curious as to his nutritional needs that correlates with the drug regimin that he takes. What types of food will compliment his drug coctails? What types of food would be a detriment? Whick if any of what he is taking needs to be on a full stomach or empty stomach?

i guess thats all i have for now.. thanks

Response from Dr. Holodniy

Viral load, good = <50/ml. Average = 500-10,000/ml. Bad = 10,000-100,000/ml. Ugly = >100,000. With a viral load of 16,000 and CD4 count of 200 and on the regimen you stated, if he has not recently just started (within the last 3-4 months) he needs his therapy changed. A change up or down of a minimum of 3 times, is considered significant for viral load changes. Your partner is on HAART. A dose missed here or there is OK. You may want to consult with the doctor about changing the Viracept to 5 tabs (1250mg) twice a day. He can take that with combivir which is already given twice a day. That will improve adherence. Food is irrelevant for combivir absorption. Viracept is best taken with a light meal.

MH



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