Hi,

I recently started taking HIV medicines, May 22nd of this year to be exact.

When I started medicine, my VL was about 2,500. My CD4 was about 350. The resistance profile done showed NO resistance to any of the HIV medicines.

2 weeks after beginning treatment, my VL was at 250.

4 weeks after beginning treatment, my VL was 130 and my CD4 increased to over 450.

At 6 weeks after treatment, my VL was at 96.

Why is my viral load not undetectable yet? Am I experiencing some sort of HAART failure? During those 6 weeks I did have rectal surgery for HPV, and a second emergency rectal operation soon afterwards to stop the bleeding that the negligent surgeon caused during the first surgery.

So, again, why no undetectable status yet? Should I have my doctor increase the Prezista dose to 600 mg twice a day, instead of 800 mg once a day? If my response to my regimen is normal, then what is the upper limit of when a person beginning treatment should reach an undetectable VL?

Thanks so much for all your help. God bless.

- Worried in NYC.

Dear worried fellow- NYer,

Your response is not out of line from what can be expected. Your initial response has been quite good. Most people have achieved an undetectable viral load by 4 to 6 months. It may take longer for those people starting out with higher viral loads (greater than 100,000 or so).

Best, Joe