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not quite undetectable
Nov 4, 2007

I have been HIV positive since the days when it was still called HTLV-III... I have been on my current drug combo for some four years, and my T cell counts have ranged between 300-350, but over these four years, my viral load never is quite at undetectable (and never has been at all, actually). The last year and a half, it as been 156, 215, 130, 222, 150 and 194. My doc says its "close enough"... Your thoughts?

Response from Dr. Sherer

I would need more information to be able to answer the question completely, so please take the suggestions below and talk to your doctor about them.

It does appear that there is a greater risk of virologic failure for someone who does not achieve a viral load below the level of detection, i.e. below 50 or 75 copies/ml. There may be treatment alternatives that you and your doctor can consider to achieve full suppression, including intensification of the regimen with an additional agent, or a change to a new regimen.

The kinds of information that would be useful include your current and previous ART regimens, and your response to them by CD4 cell count and viral load, the results of any resistance tests done since you started therapy, the results of a resistance test on your current regimen, side effects of the above, other opportunistic infections and medications, and other information.

There are new medications in the current era that have led guideline panels to recommend that the goal of therapy, even for people with heavy previous treatment experience, be for complete viral suppression to below the level of suppression. You and your doctor should review your treatment options in light of these new recommendations.

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