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Lipodystrophy and WastingLipodystrophy and Wasting
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viral load tests
Sep 3, 2000

Dear Doc,

I have just been diagnosed HIV pos, July 6 2000. My first viral load and cd4 tests were 271,000/262, using a 1st generation pcr test. My second tests used a 2nd generation pcr test, vl was 25,500 and cd4 was 230, without meds. What is the difference between these 2 tests? I started meds, 08/18/00, sustiva, d4t, and 3tc. Reading other questions I don"t think I want to remain on the d4t due to fat redistribution, would it be alright to switch to combivir this early, to avoid this problem. Am tolerating meds very well. Get retested in 3 weeks and see doc in 5 weeks. Thanx :-)

Response from Dr. Fisher

There sometimes is a lot of discrepancy between viral loads. Sometimes due to the tests themselves (different labs, different techniques), sometimes to you (different times, maybe different things occuring within your body) or simply for unknown reasons.

However your CD4 is certainly low enough to begin therapy. As to d4T, the jury is still out. It may or may not play an increased role in lipodystrophy but certainly other factors contribute. But yes, you could switch to combivir without harm. Be advised though that virtually any antiretroviral regimen can be and has been associated with fat redistribution. Sustiva with either d4T/3tc or with combivir is an excellent choice.

good luck


Alvan Fisher, M.D.

Milk Thistle
Oxandrin and Juven - safe together?

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