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Trouble getting to undetectable

Aug 27, 2017

Diagnosed December 2016, VL 650,000 Genotype: no drug resistance Started triumeq January 2017 March VL 85 May VL 25 August VL 67

Absolutely 100% adherence. Otherwise healthy, not taking any supplements etc that would reduce absorption... was surprised that I wasn't undetectable by now. Am super anxious by the results ... doctor considering switching me from triumeq to tivicay & descovy. What are your thoughts? Why is this happening ? I am anticipating the worst; that I will end up failing this regimen and get resistance...I would really appreciate your opinion on this.

Response from Dr. Holodniy

Sometimes with high HIV viral loads it can take longer to get to an undetectable viral load. Sometimes it can take longer than 6 months. You don't indicate what your CD4 count and percent have been doing during this time frame, but I assume you have had a good response. It was good that a pretreatment resistance test was done, and I assume the test also looked for integrase inhibitor resistance (like the dolutegravir you are on). The suggested change is a modest one, and is not unreasonable. You would remain on dolutegravir, which is the backbone drug, and descovy would be two new drugs that very closely related to the ones in Triumeq. You could give that a try, or stick with what you are on currently. I don't think at this point resistance is an issue.



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