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Jul 19, 2006

I was recently diagnosed in late Feb with a CD4 136 and VL of over 100000. I was started on Sustiva and Truvada and have been taking them for 16 weeks. My results have been as follows at 4 weekly intervals. CD4 226 VL 1600, CD4 300 VL 300 and last week CD4 260 and VL 240. Should my VL not be undetectable by now and why is my CD4 now going backwards. My Doctor says I am doing OK and not too worry, I m not convinced. Furthermore he now says I need not be seen for 3 months, is that normal? Thanks for your time

Response from Dr. Young

Thanks for your post.

You've had a very nice initial response to treatment-- your viral load as decreased over 99% (2 log10) in 1 month and have had a doubling in your CD4.

We generally expect viral loads to reach that magical undetectable level (less than 50) within 3-4 months of treatment; patients who start with high viral loads (like you) can take longer. The key initial measure isn't undetectability, but the magnitude of the VL decrease.

Further, your doctor's follow up time line is entirely in keeping with standard of care (you could actually argue the converse, that weekly viral load and CD4 testing is more than usual).

Sounds like you've got a good doctor.

I hope this helps. BY

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