|worried guy meds problem
Feb 1, 2012
Hello, i have been on combivar and sustiva for ten years with no problems but in november for no reason suddenly my viral load went up from below 40 where it has been for years to 580 because of this the meds where changed to ritonavir darunavir and Truvada as my doctor felt the meds had failed ive had no side effects which was good from the new meds but today i went for my readings expecting my viral load to be down a lot .i was shocked to find it had not gone down atall and reminded in 500s so where my doctors who where unsure why the meds had not worked and have some effect on my viral load i have had a resitance test and i was ok on that -i have been on the new tables since 14th december .could you tell me if you have any thoughts why the new meds have had no effect on controlling my hiv im a little worried as you can tell thank you for any help you can give me with ur reply nic
Response from Dr. Henry
A viral load in the 500 range is not a cause for panic but does suggest either some problem with adherence, absorption/metabolism of drugs, or resistance. Resistance tests are not full proof and can miss low level resistance and can be less reliable in the HIV range of 500 copies/ml in some labs. I would review other drugs and foods that you are taking (such as grapefruit or St Johns wort)with your HV doc or pharmaacist, consider taking the daruanvir in BID (600 mg with 100 mg ritonavir) dosing, and perhaps use Truvada instead of Combivir while missing zero doses--then repeat viral load. Most of the time the virus should supppress-if not then adding another drug (etravirine or raltegravir might be considered) would be worth considering. KH
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