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folowup to "How am I doing"
Jan 28, 2004

Dr. Young,

Sorry, I should have put the K sign...my viral load numbers-- were 289,000 at start and my current viral load is 131,000 after the 2 months treatment. And again, my CD4 count at start was 224 and now is improved to 306. Thanks very much for your comments your service is fantastic!

NJ

Response from Dr. Young

NJ--Thanks for your follow up and nice comments.

Your viral load results are important to review, and I'm glad that we have a chance to look at them. In contrast to my earlier post, I'm actually very concerned about your viral load and lack of significant decrease since starting on therapy.

Typically, I like to see at least a 99% decrease (if not more) by 2 months into a first treatment regimen. This would predict that your viral load should have dropped to at least 3,000. The fact that it was 130,000 suggests to me that either there's a problem with adherence (it doesn't sound like it) or that you might have been initially infected with a virus that is resistant to one or more of the drugs that your currently taking.

In my practice, for example, over 10% of new patients have evidence of significant drug resistance-- it's for this reason that we do resistance tests on everyone-- whether they're recently or chronically infected with HIV.

Now, what to do? I'd review your results carefully with your doctor-- make sure that the viral load result is repeated soon; in my office, you'd also be getting an HIV genotype and phenotype to facilitate making any needed adjustments to your therapy.

Sorry to have to bring sober news. Stay in touch, let us know how this turns out. Good luck, BY



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