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"Viral load effect on medication effectiveness"
May 10, 2005

"Do spikes in the viral load cancel the effectiveness of my medications?"

Response from Dr. Conway

Low level spikes in viral load (up to say, 500 copies/mL) are often not significant. They are often random results or may relate to occasional non-adherence to medications. I take this as an opportunity to go over the medications with my patient and make sure they are being taken regularly, and appropriately (with or without food, once or twice a day, etc...). This may lead to a small change in the routine of taking the medications, increases adherence just that little bit and the next viral load is undetectable again, and the long-term efficacy of the regimen is preserved.

If the spikes in viral load are higher (say > 2,000 copies/mL) this may be more of a cause for concern with respect to high-level breakthrough, the dewvelopment of drug resistance and the need to change therapy. There is a more urgent need to go over adherence, and repeat viral load testing in the near future to establish if there is a trend towards failure of the regimen.



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