https:\/\/i-base.info\/guides\/8851<\/a>.<\/p>\nHigher drug levels make dolutegravir more potent against the virus. When there is a concern about drug resistance, dolutegravir is prescribed twice daily (i.e. every 12 hours) so this might also be a short-term option.<\/p>\n
If you have perfect adherence with once-daily taken with food and the viral load is higher than 200 with the next viral load, then it is worth getting a resistance test (including for integrate) and discussing about either switching to twice daily dolutegravir or to a different combination. Resistance test can still work when viral load is below 500.<\/p>\n
One reason to be hopeful, is that blips have been reported in dolutegravir studies which resolved without changing treatment – even when changing treatment was recommended.<\/p>\n
Given the overall cost of your treatment, it is fine to have a few more frequent viral load tests now until this is resolved.<\/p>\n
If this is a real viral rebound, the risk of waiting a month is that this increases the risk that more serious drug resistance could\u00a0develop over this time.<\/p>\n","protected":false},"excerpt":{"rendered":"
So i\u2019ve been diagnosed for a year now with my viral load dropping from 200,000 to undetectable in a month on raltegravir and Truvada. In May of this year i changed treatment to Triumeq as i found i occasionally missed the evening dose of raltegravir (Although i was still undetectable) and my doctor thought changing to the once a day pill would help overall.<\/p>\n
Taking the pill once a day did make it much easier and I had less anxiety about being out incase i didn\u2019t get home in time to take it. <\/p>\n
Since starting Triumeq my viral load has become detectable again. Since May it rose to 27 in July and my latest result, yesterday, it was at 154 which seems like quite a steep rise?<\/p>\n
The doctor doesn\u2019t really understand why it has risen as i haven\u2019t been taking anything such as vitamins that could react with the Triumeq, i haven\u2019t been unwell and i don\u2019t have any other STIs.<\/p>\n
I take the pill roughly the same time every day with a window of about 1-2 hours. Occasionally i forget and maybe take it about 4 or 5 hours out and i\u2019ve forgotten to take it maybe twice in 2 months. But this is similar to how i took the raltegravir\/Truvada, in fact i\u2019ve probably been more strict with times with the Triumeq. I assumed once i was undetectable it wouldn\u2019t matter so much if i was out by a few hours.<\/p>\n
The doctor said that if ive become resistant that rules out going back to my original tablets as they\u2019re in the same class as Triumeq, so would that mean i\u2019ll be on older medication with more side effects?<\/p>\n
Should i be worried about the rise in my viral load? And is it possible i\u2019ve become resistant even though i\u2019ve taken my pill more or less every day? <\/p>\n
It\u2019s really worrying me as being undetectable made me feel better about the virus as it meant i\u2019m not infectious. For now though i\u2019ve been advised to be super strict with times for the next month until i revisit the clinic.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,7,9,10],"tags":[],"class_list":["post-12027","post","type-post","status-publish","format-standard","hentry","category-adherence","category-all-topics","category-cd4-and-viral-load","category-changing-treatment"],"_links":{"self":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/12027","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/comments?post=12027"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/12027\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/media?parent=12027"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/categories?post=12027"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/tags?post=12027"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}