The Body: The Complete HIV/AIDS Resource
Follow Us Follow Us on Facebook Follow Us on Twitter 
Professionals >> Visit The Body PROThe Body en Espanol
Ask the Experts About

Choosing Your MedsChoosing Your Meds
Rollover images to visit our other forums!
  • Email Email
  • Glossary Glossary

Newly diagnosed and viral load too low for genotyping
Nov 27, 2009

I was infected with HIV-1 on 9/15/2009 and diagnosed on 10/6/2009. The labs are as follows: 10/15/2009 CD4 - 361, VL - 532, 11/05/2009 CD4 - 446, VL - 283. In both rounds of labs, they could not do any drug resistance or tropism testing because the viral load was too low. After reviewing a lot of primary studies, I want to start taking the meds as soon as possible. What are your thoughts on which meds to choose and when to start.

Response from Dr. Young

Hello and thank you for your post.

I'd generally agree with you regarding when to start HIV treatment. It's good news (in a way) that your viral load is so low- this means that you have a better prognosis overall and don't really have any risks related to the potency of your HIV medications.

Unfortunately, this low viral load also makes it technically very difficult to obtain the HIV resistance test that is recommended in the US and Europe. Therefore, recognizing that non-nucleoside resistance is the more commonly transmitted resistance, avoidance of a non-nuke regimen is usually done (at least by me) in this circumstance; to avoid prescribing an initial regimen that your virus might already be resistant to.

Hence, we'd usually start with a two nuke combination-- usually Truvada (tenofovir+FTC) or Epzicom (abacavir+3TC) with a boosted protease inhibitor (alphabetically, atazanavir, darunavir, fosamprenavir or lopinavir). This is particularly the case since ritonavir-boosted PIs are very potent, even in the face of most types of baseline resistance.

I hope this helps.


Doctor prescibed PEP for 21 days

  • Email Email
  • Glossary Glossary



This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

Review our complete terms of use and copyright notice.

Powered by ExpertViewpoint