Starting Treatment with high VL
Jan 11, 2004
Hi, I was just wondering if you could please give me some advice on starting treatment with a high vl, my cd4 350 and vl 120k
My vl has always been high, and now is the point to start treatment i was wondering if there was a good treatment to start with as my vl is so high.
If you could give any advice i would be most grateful as i dont want my first treatment to fail.
Response from Dr. Pierone
A viral load of 120,000 is really not so high. Starting on a NNRTI-based regimen (Sustiva or Viramune) as linchpin drug along with 2 nukes (Viread and Epivir for example) should be effective. The DHHS guidelines also list Kaletra as an alternative for the linchpin drug, but this involves more pills per day and a greater likelihood of side effects. The main way to prevent failure of a first regimen is to not miss any doses of you medications. Good luck and let us know how things go.
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