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what Med do you think should be added

Apr 25, 2010

I wrote to you back in Feb 2010 about not being able to get to undetectable levels after being undetectable for two years. My resent VL was on 3-2010 180, Jan 100, Dec 160 Nov 360 Oct 130. I have not been able to get back to undetectable levels. I am currently on atripla and ziagen . My doctor wants to add another med to my therapy. In your answer to my question about what's going on you questioned the fact that I was on 4 meds and that was not the usual course. I am fearful that my doctor is going to add another med and that would make it five. do you think this is a good idea? Help. Pete from NY

Response from Dr. McGowan


Depending on how high the viral load was before treatment, it might take 12 to even 16 weeks to get to undetectable. Now you have had 6 months (24 weeks) at a fairly flat, low-level viral load. Assuming you have not missed doses this may indeed be a good time to consider "intensifying" the treatment to see if it brings the level to undetectable. If that does not change the pattern you could eventually stop the extra drug, but if it works you have answered the question and benefit in the long-term.

Best, Joe (also in NY!)

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