Hello Doctor- I have been HIV positive for ~ 2 years now, on Truvada with Isentress, VL is undetectable, CD4 count 680. I am very adherent with my meds, never miss any doses! When I started HAART, my CD4 count was 189, VL ~ 5 million (this was during acute infection as my HIV antibody was negative). My question is: at this point would it be safe & effective to drop to one or two meds instead of 3 to maintain viral suppression. As I said, I am very adherent. I just would like to use the LEAST amount of meds possible to maintain good viral suppression. How likely is it, that by just staying on Truvada for example, my VL will soar up? Thanks for advice.

Hello and thanks for posting.

Dual or single drug therapy is definitely not recommended, even after suppression with a three drug regimen, like Atripla. Indeed, this strategic question was asked in clinical trials in years past, with negative results.

I would not advise continuing on Truvada alone, you'd risk treatment failure and the development of drug resistance.

BY