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right meds?
Oct 17, 2006

Dr

I got my week 31 results today which show VL 150 CD4 370 15%. 31 weeks ago I started on Sustiva/Truvada with VL >100,000, CD4 236 17%. The only time I have got a <50 was at week 26. Whats going on, I am on the wrong meds. Resistence testing done and I am 100% adherent to taking my meds on time,every day. Any suggestions?

Thanks

Response from Dr. Wohl

I would not get too worked up, yet. Instead, I'd check another viral load. No need to wait. You can do this now.

If you have persistently elevated viral loads then I would be concerned that you had resistance before starting the meds that was not detected by the resistance test. Otherwise, it could just be that this particular combo is not as effective as we would like against your virus.

If the VL does return in the hundreds, I'd get a genotype (could draw now with the repeat VL if not cost prohibitive in case there is enough virus to look for resistance). I would then modify your meds by changing to a ritonavir-boosted protease inhibitor.

DW



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