Hello Dr., I was diagnosed with HIV one year ago and started taking Atripla 4 months ago. My CD4 went from 387 (17%)to 555 (28%)and my Viral load went from 183,000 to 108 but it's still not undetectable. Should I be concerned that I am not responding to the medication? I read that mostly everybody that starts on Atripla becomes undetectable within a month. Thank you for your response!

The average time to become undetectable with an Atripla-based regimen is 4-6 months, and people who start with higher viral loads will take longer. What you remember reading was wrong. You can relax with the information that your drugs are working hard on your behalf, already achieving a 183,000 to 18,300 (one log) to 1,830 (2 logs) to 183 (3 logs) to l08 copies/ml, overall a greater than 3 log decline in your viral load, all in only 4 months. These are good results and an unequivocal downward trend.

You are quite likely to be undetectable at your next visit, and for innumerable visits thereafter....but only if you maintain your vigilance and take every dose as prescribed. This regimen has a fine track record, and 8 of 10 people have this kind of response on this regimen, but you have to resist the temptation to relax too far and lapse with your adherence. You have to the heavy lifting here, and never let down your gaurd. If you can establish a routine that is simple and iron-clad reliable that will enable you to take that medication every day at the same time, no matter where you are or who you are with, whether on a weekend or weekday, at work or on holiday, you can expect to have these same results for many months and years to come.

I encourage you to talk to your doctor about your concern and these observations.