Hello Docs,

I have been on medications for 3 months and have had 2 blood works so far. Unfortunately I still have not reached undetectable with VL at 350 and CD4 rising just a little bit.

I'm on Boosted Fosamp. and Kivexa. Two issues pls

1- Is it normal to be detectable after a bit over 2 months on treatment? My resistance test showed non.

2- My Triglycerides have sky rocketed to 550! What can I do, and is this a case where changing meds is due? Please advice.

Thanks a lot for your help...

It often can take many months to reach undetectable HIV levels (the higher the pre-treatment level of plasma HIV RNA the longer it usually takes to reach undetectable). A subset of patients (? genetic factors) will develop high triglyceride levels on boosted protease inhibitors. Diet and exercise can often help reduce levels but sometimes treatment is needed (ie fibrates, niacin, fish oil, statins). I have seen triglyceride levels in the thousands so your level, though of concern, can often be managed and tolerated and doesn't pose much of a short term risk. Boosted fosamprenavir doesn't seem to have notably higher lipid levels compared to many other choices so a switch at this point is often not needed until more time has elapsed to observe the trends. KH