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Viral Load increasing
Jul 8, 2008

My POZ partner has been taking Atripla for a few years. His viral load was undetectable for 2+ years. Now it is rising ... the last three blood tests it went from, 4300, to 4700, and now 16,000! We are panicking. The doc doesn't seem overly concerned, and has not moved up his next appointment which is a few weeks away.

Should we push to get him to the doc sooner?

Response from Dr. Sherer

You are correct that these numbers are alarming and suggest resistance to the current regimen. I would also agree that there is no reason not to act promptly to get the results of a resistance test and change to the next regimen. Panic won't help this situation, though, nor does the situation warrant panic. He and his doctor should be able to come up with a reasonable second line regimen with which a return to an undetectable viral load for a prolonged period of time is likely to occur.

So, yes, I think an earlier appointment is a good idea, if the results of a resistance test are available then. Note that it may be the case that the appointment is the soonest available for his doctor with that information available. When he next sees his doctor, he can ask about why there was this delay.

In the meantime, it would be useful to take advantage of the time and to think for yourselves whether there were any lapses in taking medication that might have contributed to the loss of effect. I suggest this not to assign blame, but to encourage a review of all of the possible factors that might have contributed to this virologic failure, so that they can be corrected before the switch to the next regimen.

As always, I suggest that you talk to your doctor about your concerns, and this response to your question. If you are not satisfied with the answer, you and your partner are always free to exercise your right to obtain a second opinion from an alternate doctor.

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