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VL still very high after 6 weeks on meds
Sep 25, 2000

My brother tested HIV+ in late June. VL=~160,000 t-cell=~1000. In early August he started on Combivir and Sustiva. This week he had his VL checked again and it's ~250,000 (no t-cell test) The Dr. felt that there should have been a 2 log lowering of his VL. He has recommended he be retested in 2 months and at that time if the VL hasn't come down consider switching meds. Could he have an HIV strain that is resistant to his current meds? Should he request switching meds sooner rather than later? Thanks in advance.

Response from Dr. Holodniy

If he is taking the meds as prescribed (in which case a lack of adherence should not be an issue), he is on no other drugs which could affect the blood levels of his HIV meds, then resistance could indeed be a factor. I am not sure I would wait 2 more months. I might get a resistance test now, so you can anticipate what in the current regimen needs to be changed.


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