I have had a low viral load of around 60 to 70 the last 3 times i have had labs (since the end of 2007). My cd4 was 691--down from around 860. My cd4 percentage went from 37% to 32% since my last labs. I am currently taking Kaleetra and Truvada. My doctor says that if i have a low viral load at my next appointment that she will have to shift medications. She said this will use up all first line treatments. I can understand why she has to change because of resistance but i hate to use up all my options and switch so soon. Do you think that the low viral load is a reason to change? My Dr is great but i just wanted to get another opinion because i worry about using all my options. Thanks for your opinion and thanks so much for all you do and the brillant website.

You don't indicate whether this is your first HIV treatment regimen, or you have been on other HIV treatment regimens. Although I understand your doctors concerns, given the persistently barely detectable viral load and the CD4% drop, I am not sure I would switch medications just yet. If this is your first regimen, you have many treatment options, if a change were necessary. Your scenario is most likely the result of viral load assay variability and not treatment failure. Failure tends to show up when the viral load starts to rise to 500-1000.