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HIV Drug ResistanceHIV Drug Resistance
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Jan 25, 2002

I begun Medication on May/01 comvivir, norvir, fortabase, currecntly on a clinical trial after two month VL1000 T4 276 two month later vl undetatable t4 320 in november last tested VL 60 t4 346. My doctor think it may have been cross contimanation at the lab.Should I be concern about drug resistance though I have been retexted to see current situation

Response from Dr. Little

I do not know what your starting viral load was, but a viral load of 1000 after 8 weeks of therapy sounds quite good. This is further supported by your viral load dropping to below the limit of detection after several months. Your most recent viral load of 60 is not I believe a cause of great concern. While this number is above the cut-off of 50, there is not a great deal of data to suggest that these very low levels of virus are a predictor of impending failure. Viral loads of greater than 200 - 400 are more clearly predictors of impending virologic failure. With a viral load of 60 and a very good CD4 cell response, I would simply retest your viral load - the choice of when is a bit more complicated. Many providers would wait another 2-3 months given that the risk of virologic failure seems low. Alternatively, if you have access to a medical plan that will provide more frequent testing, you might have one done after 1 month, mostly for reassurance, but also to rule out the unlikely chance that this viral low level of viremia was a warning of early virological failure.

How fast to suppression is acceptable
results are suspect

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