how bad is it to do this???
Aug 24, 2002
how dangerous is it to start a sti when you are blipping? I'm talking about a low end blip, but yet one that was not there in the past.The problem is it is low enough <100 not to be able to do a resistance test so it is a grey area.I know many people start sti's when they are undetectable(safest scenerio) but given the fact that the current assays are acurrate down to 50 copies it seems feasible that many people(myself probably) have been running around with very low levels of virus (in the 1 to 49 range) without even knowing it.What is your opinion on people who are never actually "true 0's" Thank you
Response from Dr. Henry
My answer would partly depend on your past treatment history and current regimen. I would be nervous about stopping a 3TC or NNRTI (i.e. nevirapine or efavirenz) containing regimen in the midst of some blipping to which might further increase the risk of developing resistance during the week the drug levels are falling. Some experts are now adding a drug such as Kaletra (or continuing it) for a week after 3TC and the NNRTI are stopped. Also if you had a low CD4 count prior to therapy (<< 200), an AIDS defining condition, or high viral load just prior to starting therapy (>>100,000) then I would be more nervous about stopping treatment. KH
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