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Feb 28, 2009

Hi Doc,

I have started on Atripla in November, my labs were VL 600000 and CD4 99 at the time. After 1 month, my VL dropped to 1800 and CD4 went up to 154. I was happy with the results. However, last week my 3 month lab results came and, I was disappointed to see VL 1900 and CD4 184. Although CD4 went up, the fact that VL is still high - and even higher than before - scared me. What do you think is the reason behind this? Can this be resistance, or a simple blip? Am I still on track to undetectable VL?

Response from Dr. McGowan

Thank you for your question. The best thing you can do is to maintain your adherence to Atripla, and get your viral load rechecked as soon as possible (your question was posted about a week ago)and if the new viral load is around the same number or higher it might be appropriate to check for viral resistance. How quickly the viral load achieves undetectable levels can vary from person to person and the test itself can vary such that even if the same sample is run twice one can get slightly different numbers. While all of this is being sorted about it is critical to maintain adherence to your Atripla. Good luck, Joe

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