When Should I Change My Treatments, and Which Drugs Should I Switch To? en español
How would I know if my drugs have stopped working?
You and your doctor will need to keep an eye on your viral load and T-cell counts upon starting a treatment regimen and over the months and years you continue to take it. If any of the following occur, it might be possible that your drugs aren't working correctly:
If your viral load is not lower than 400 after 24 weeks (six months) of starting therapy. An early way to tell if a drug regimen is being effective is to look for a 90% drop in viral load between 2 to 8 weeks after starting therapy. For example, if your viral load starts off at 50,000 and drops to 5,000 after 8 weeks, chances are good that your viral load will be less than 400 after six months of treatment.
If your viral load is not lower than 50 ("undetectable") after 48 weeks (almost a year) of starting therapy. Undetectable does not mean zero -- it means that your viral load is less than the minimum amount of virus the test can detect. Today's more sensitive tests can measure 50 copies/mL or above, so undetectable means "less than 50".
If an undetectable viral load is detectable again. Some experts believe that a viral load that goes from being undetectable to detectable is a possible sign of treatment failure. But the results of one viral load test showing this jump is nothing to panic about. You should repeat the test – it may simply be an error or nothing more than a temporary "blip." If a second test confirms the results of the first test, it might be time to alter your regimen.
If your T-cells do not improve while on combination therapy, regardless of viral load. No, it certainly is not only about viral load. The goal is to keep viral load low and the T-cell count high. A T-cell count should improve, on average, by 150 during the first year of treatment. If you started therapy with a low T-cell count, it could take more than a year to see your T-cell count improve by this much. You and your doctor might want to consider altering your drug combination if your T-cell count does not improve by at least 25 to 50 during the first year of treatment. And if your T-cell count continues to fall while you are on treatment, changing your medications will likely be necessary.
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