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Ask the Experts about Drug Resistance and Staying Undetectable
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REDUCTION IN VIRAL LOAD
Feb 2, 2008

What is the time taken for a person with a CD4 count of 700 to achive a undetectable viral load whose is on ART with Limodividine, Satuvidine & Neviprine(Triomune)?

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   Response from Dr. Sherer

Most patients will achieve a viral load below the level of detection within six months of the start of ART. For a lower viral load level at baseline, e.g <100,000, the expected time to undetectable would be shorter, i.e. three months or lower. For a higher baseline viral load, e.g. > 1,000,000, it may take more than six months, and outlyers will require 9 months or more to achieve full suppression.

The important thing for you is to work as hard as possible to take all medication doses without fail, on time and as prescribed. If you can achieve this, you will be doing everything possible to get the best benefit from your ART.

You and your doctor will get a clearer idea of the likely time that will be required for you to achieve a viral load level below detection when you have your first viral load repeated after one month (if viral load testing is available to you in your region of the world). Your doctor will be able to look at the slope of the viral load decline and make an estimation of the remaining time to full suppression.

Since I have been asked this question for a specific reason in the past, I will also note that there is NO viral load level below which a person is no longer able to transmit the virus. Both transmission from mother to fetus and sexual transmission have been reported to occur, even when the HIV+ individual had a viral load that was undetectable. I would discourage you from thinking that unprotected sex would be safe, for example, once you had achieved a viral load below detection. While it can be said that a viral load <1,000 copies/ml is less likely to lead to transmission than a viral load of 100,000, it cannot be said that either level is 'safe', and my recomendation is that individuals with HIV continue to practice safe sex, even with a fully suppressed viral load below the level of protection.

I urge you to talk to your doctor about your question and these responses.



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