Please advise what you would do if, for the first time since beginning treatment (Abacavir, Neverapine, 3TC) 2-1/2 years ago, your VL became detectable by ultrasensitive assay (105). How soon should I retest? After how many detectable results should I consider changing meds? Should I do resistance testing before making another medication choice? (47-yr.-old woman, nine years positive, average 300-400 CD4 cells). Many thanks!

I would test again in a month or so, and see if this was just a "blip", in which case it will be back below 50, or a significant trend, in which case it will probably be higher. A resistance will not be possible if the viral load is still 100. Most reference labs require a viral load of > 1,000 in order to have enough HIV copies to do the test.

MH