Jun 10, 2003
If a patient who is severely anemic with hemoglobin count of 9 along with a CD4 count is 88 and a viral load of 400,000. The doctor has started this person on the following medications: Videx EC 250mg 1xday, Viread 300mg 1xday, Epivir 150mg 2/day, Sustiva 600mg along with 2 teaspoons of Mepron a day. Now how soon should the patient's CD4 go up along with a reduction of the viral load.
Response from Dr. Young
Thanks for your question.
The regimen that the doctor has prescribed seems like a reasonable one, though has not been formally tested in clinical trials. It should be pointed out that the lamivudine (Epivir) can be taken 300 mg once daily-- generating an entirely once-daily drug regimen when combined with didanosine (Videx EC), tenofovir (Viread) and efavirenz (Sustiva, Stocrin).
I usually like to see a 90-95% reduction in the viral load after one month and a 99% reduction by 8-12 weeks. This would mean that the viral load after one month should be 40,000 or lower after one month-- ideally, about 4000.
CD4 cell count rises tend to lag behind the dramatic drops in viral loads, but can increase at least 100 cells/year, if things go according to plans. (This averages to about 10 cells/month, if your trying to calculate.) Don't hold me to this, as some persons have much greater increases and others slower-- it depends on the overall health of ther person, how low the CD4 count was prior to starting and other medical complications. BY
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