Mar 8, 2005
On 11/12/04 I was undectable with a absolute CD4 helper count of 507. As of 2/02/05 I am detectble and my absolute CD4 helper dropped to 272. I am taking Sustiva,Viread and Epivir. I have been 100% compliant since starting in March 2004. Should I panic? What are my options? I've been stressed lately and does this mean drugs are failing already? Thank you for your response. Mike
Response from Dr. Conway
If you are quite adherent to therapy, the first thing I would do is repeat the test to make sure. The viral load test often "blips" to low levels (usually < 2,000 copies/mL) for no good reason, and goes back down. As for your CD4 count, acute viral illnesses (such as the flu in the winter in the Northern hemisphere) can often cause the count to go down, and it goes back up when the illness clears. A clue here is that the CD4 count goes down but the percentage is stable.
Now, if the repeat test still shows that your regimen is not working, we would normally do a resistance test to help guide the selection of the next regimen. Your regimen is interesting in that a very few mutations could lead to a loss of efficacy. However, if this is all you have been on, there are almost certainly other options for you that will work.
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