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Viral load drop with Combivir/Sustiva
Dec 20, 2002

One week ago, I began treatment for the first time using the Combivir/Sustiva regimen. My last viral load was 22,300, and my t-cell count was 179. In general, assuming treatment is effective, how quickly will the viral load drop? Should I expect a huge initial decrease at my two-week follow up, and then a more gradual decline to undetectable (good case scenario, of course)?

Response from Dr. Young

Thank you for your question.

The combination that you're taking has been used with considerable success for the past several years and has been shown to be very potent and tolerable.

Assuming that your virus was wild type (drug susceptible) when you started treatment, we usually expect about a 1 log (or 90%) reduction in viral load after 2-4 weeks on therapy. It is not unusual to see greater drops, even 95-98% reductions. If this is so, then we'd expect your viral load to be down to something around 2000.

Yes, viral loads drop fastest in the first weeks of treatment, followed by a second-phase, slower decline to undetectable levels (if not achieved in the first weeks).

Hope this helps, -BY

HusbandHIV+ and WifeHIV- III

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