Thanks for getting in touch.
Both the US and UK guidelines say that viral load should be undetectable within three months. However, sometimes this takes longer, especially if viral load is very high (over 100,000 copies/mL).
For more see here:
Although it is annoying that the viral load was tested before, as your CD4 count was still pretty good, viral load is unlikely to have been very high.
Also, as you have been adherent (i.e. not missing doses) you may just have been unlucky and have had drug resistance to one of your meds before you started treatment. This would have mean that only one or two drugs were active, even though you were taking a full combination.
Depending on where you live, up to 10% or even 20% of people who have not used treatment, have some drug resistance before then start. So you have just been unlucky. It is sometimes easier for doctors to blame their patient for not taking meds, but if you had drug resistance without realising this, there is nothing else you could do.
If the latest results still have a similar viral load, then your doctor is right that you need second-line treatment. Ask whether a resistance test is available, though this is less likely.
If you start second-line treatment, please go back to very good adherence. The next treatment is then likely to get your viral load to undetectable.
Information on this website is provided by treatment advocates and offered as a guide only. Decisions about your treatment should always be taken in consultation with your doctor.