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Sustiva/Truvada Viral Load Undetectable but CD4's Not Rising
Apr 2, 2006

I have been on the Sustiva Truvada combination for four months. After the first month, my viral load went from 100,000 to undetectable and is still currently at undetectable. My CD4's, however, have remained unbudged at 292. My doctor suggests that there is some research indicating that it may be beneficial to switch to a protease inhibitor. Should I wait and see if my cd4 count rises or should I look into the protease inhibitor option?

Response from Dr. Henry

CD4 recovery is usually but not always seen with high level suppression of HIV replications. Some patients don't have much thymic reserve from which CD4 cells can be replenished. There may also by a genetic component. I often wait for 3-6 months and then if not improvement on a particular regimen then consider a switch. For some patients better CD4 recovery may be seen on a protease inhibitor based regimen (though your current regimen usually does quite well from the CD4 perspective). KH



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