Q and A

Question

What do the results of my husband mean?

My husband started on Atripla in September of ’08. At that time, his CD4 was 175 and VL was 2700. Six months later, his results are: CD4 258 and VL 175. What does this mean? Is this good? His doctor said he expected him to be undectable by now so he may have to change meds. Should he concern himself with increasing his CD4 count if his VL is low?

Answer

The results of your husband mean that he responds to the therapy-the viral load goes down and the CD4 goes up.

However, depending on the therapy and some other factors, it is expected that the preson will have an undetectable viral load after 6 months of initiation of therapy.

The reasons for not achieving that may be very complex-starting from initial resistance, medicines not well metabolised and as a result low concentration, poor adherence to the therapy, concomitant use of ARVs with some other medicines, genetic background, not following the food requirements, etc.

Your husband’s doctor considers switching the current therapy to something else as he/she wants to make sure that your husband gets to undetectable level, which is the goal of the ART. Most probably, the doctor will wait for one more set of results and then will make a suggestion for a switch (in case your husband is still detectable). If he is, then all the better, he will be able to stay on the current treatment.

All these aspects are very well explained in the i-Base booklet on Changing treatment.

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