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Should I Switch?
Dec 14, 2009

Hello Dr. McGowan,

I was diagnosed HIV+ in 1997. My first combo was Viracept, Epivir and Zerit. I was on those meds for several years until they stopped working and my dr switched me to Trizivir alone. After several months of that not working, he added Sustiva. That brought me to undetectable for a while. For the last 5 or so years, I've remained on that cocktail even though my VL is usually between 300 and 800. Since it doesn't get above 1,000, my dr doesn't want to switch me since we can't do a resistance test. I know there are some new meds out there now - do you think I should switch - and, if so, to what? Or do you think it's best that we stay the course and wait until my VL goes over 1,000 and then do the resistance test? Thank you very much for your time.

Alex

Response from Dr. McGowan

Alex,

It is clear now that having an undetectable viral load is the goal of antiretroviral therapy for all people. In your case it would seem possible to reach that goal with the availability of new medications. It is clear your current meds are not working and I would change the combo. As long as you are committed to treatment and are not missing doses, you should switch to a combo that would get your virus undetectable...even without a resistance test available an effective combo could be found for you.

Best, Joe



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