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Viroal load still not undectable after starting treatment

May 10, 2009

Hi Dr Robert, please keep up the great work you do for us hivers, just a quick question,

l started meds for the first time feb 20 2009, cd4 301 and viroal load 45,000 and %19 taking truvada and niverpine one dose every morning, 3 tabs

l took a blood test april 26 nearly 10 weeks into meds and my results read cd4 331 and % 24 and viroal load 451,

why have my cd4 only gone up by 30 and why am l not undectable ???

the doctor has told me to take a test again in 8 weeks,

thank you for your time

Response from Dr. Frascino


Not everyone responds to combination antiretroviral medications exactly the same way. Your response to Truvada and nevirapine after 10 weeks is encouraging both immunologically (CD4 count increasing from 301 to 331 and more impressive your CD4% rising from 19% to 24%) and virologically (HIV plasma viral load decreasing from 45,000 to 451). So far so good. If this trend continues, you'll soon have an undetectable viral load. As HIV replication is turned off (demonstrated by reducing viral load to undetectable levels), immune reconstitution improves (CD4 count and CD% increase). Assuming resistance doesn't develop you should see additional improvement in your laboratory parameters at the time of your next blood draw.

Good luck.

Dr. Bob

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