My 4 year old son has recently had his meds switched based on two viral loads >100,000. We repeated the viral load one more time just prior to the med switch. I was very surprised to see that his viral load had gone down to 36,000 where it had been for about two years. Resistance testing found his virus to be resistant to all his previous meds. It has been very trying as we have endured g-tube placement, anxiety over med selection, severe Nevirapine rash and much pain and suffering for my son. I am hoping we didn't jump the gun and change things too soon. Options are limited so we wanted to preserve as many meds as possible for as long as we could. What are your thoughts on why his viral load would change and how helpful is resistance testing in guiding tx. decisions?

I think this question got lost for awhile. Sorry. Although 2 viral loads were >100,000 and a third was 36,000 prior to treatment, this could represent a couple of things. One were there any other illnesses going on during the first couple of tests? Second this could be assay variability. Even at 36,000, I would have made the change in treatment. In your son's case, resistance testing was helpful because it confirmed failure of the regimen and justified changing his meds. I think the test can be very helpful in the right clinical situations.

MH