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How long for absorption of meds

Aug 15, 2006

I have been on Sustiva and Truvada for about 7 weeks. This is my initial use of HIV meds. I just got a call that my blood work shows all looks good (CDr count up, etc.); but viral count is up instead of the expected 'undetectable'. i have not missed a single dose of my meds; but had my Colon/Rectum/Gall bladder removed this winter due to aggressive ulcerative collitis. I have ongoing 'diarrhia' (every 2 to 4 hours). Is lack of absorption my problem? Have I developed a resistant strain as a result? Mick

Response from Dr. Young

Mick- Thanks for your post.

I'd think that it's far too soon in your treatment to conclude that you've had a treatment failure. If there's concern about any single viral load test, the very first thing to do is to double check the adherence, concomitant infections (for example, herpes) and repeat the viral load test. If your viral load stays above 1000 copies after a few months, then I'd be concerned about the potential for resistance, and resistance testing should be done (as it should have been done before starting).

Given that you've just started on meds, I wouldn't expect an undetectable viral load until month 3-6, depending on what your baseline test showed. Persons with very high baselines tend to take a lot longer to reach <50 copies.

That said, your underlying colitis does raise some interesting questions about absorption, given your frequent diarrhea. One way to determine if this is affecting your drug absorption is to obtain therapeutic drug monitoring (TDM) or drug level testing.

I hope this is useful. Best of luck, BY

Herpes Zoster and HIV

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