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Suddenly Dedectable
Feb 21, 2005

On 11/12/04 I was undectable with a absolute CD4 helper count of 507. As of 2/02/05 I am detectble and my absolute CD4 helper dropped to 272. I am taking Sustiva,Viread and Epivir. I have been 100% compliant since starting in March 2004. Should I panic? What are my options? I've been stressed lately and does this mean drugs are failing already? Thank you for your response. Mike

Response from Dr. Sherer

Panic is never a smart option. The solution to this problem lies with your doctor - did you talk to him or her about it? What plan did you work out with your doctor? I strongly advise you to take my comments below and see your doctor as soon as possible.

I would need more information to do justice to your question. How high is the current viral load? If its a single value only that is above 50 copies/ml, in the range of 50-1,000, then it might just be a blip, and the lab test should be repeated, with a good chance of re-suppression to < 50 copies/ml. If its over 1,000, especially with two or more values in that range, then it is likely that this represents virogologic failure, and its time to consider the second line regimen.

I would also need to know all the CD4 cells recently to interpret this value, as well as the CD4 percents. What you describe sounds like at significant drop, but it may not be one if the percent has not changed, or it could be attributable to another cause.

It's great that you have been completely adherent since starting medications - that is the one part of having HIV that you can control. Sometimes, even with such good behavior, regimen failure occurs.

So my advice remains to consult with your doctor, i.e. see him or her, and discuss these issues with a repeat test and a resistance test, in order to inform that choice of the next regimen.

Have I screwed up?

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