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Drug Resistance
Jan 30, 2002

My question is about my husband's med's and viral load. When he started med's his load was 350,00 and t-cell was 84. 6 weeks after he was tested again and the load was 750 and t-cell was 150. At his last test in december his load went up to 899 and t-cell went up to 180. He's been on med's for about 7 months and our fear is he's becoming resistance to the med's he's on. Right now he's taking viracept and trizivir. He's wants to get tested now for his load and resistance, the doctor wants him to wait till next month to retest his load. Should he get tested now or can we want? Also should he get tested for drug resistance? Thank you PGR

Response from Dr. Little

I must say that in patients who state that they are taking all of their precribed doses of medications, I am fairly aggressive about checking resistance test results when the viral load does not follow the expected rate of decline. Clearly there are many issues related to your husband's care that I do not know and his doctor may be making the correct decision in this case. However, based upon just the limited information you have provided, I would be concerned that a viral load of 900 after 7 months of medication (assuming compliance) is not as ideal as one would hope. I think it is reasonable to repeat the viral load now and then do resistance testing if it is still elevated or simply do resistance testing. Clearly - I cannot second guess the judgement of your husband's doctor who has much more information regarding his care than I - but I would suggest you discuss your concern and the possible options for sooner rather than later repeat viral load testing so that resistance testing (if warrented) can be performed as soon as possible.


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