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Detectable VL after 3 mos

May 3, 2005

I started treatment (Sustiva/Truvada) on 1/28/05 after being poz for 3.5 years. My starting numbers were Tcel 294 & VL 410,800. 1/31- Tcel 294 & VL 21,814 2/28 -Tcel 476 & VL 220 4/18 -Tcel 732 & VL 1,370

While I am thrilled to see my T's back at 700's and feel great with an easy 2-pill regimin...should I be concerned that the VL has gone up (blip/lab issues)? I have no resistances based on 2001 labs, so my doc wants to watch this closely - with more labs in a week. Could I just move along with VL in 1,000's or is it necessary to switch treatment to get VL down to under 50 ? Would a switch of pills be more likely a complicated one?

Response from Dr. Pierone

This increase in viral load may be an anomaly or a signal of early regimen failure. Close follow up with monitoring of the viral load trend should provide the answer sooner rather than later. If this was simply a glitch, then the viral load will resume the downward course to become undetectable. If the viral load continues to remain at this level or increases, then a resistance test should be done to see what is happening before deciding on the best response. I assume that adherence has not been an issue. Let us know how things turn out. Thanks for posting.

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