Changing Medications

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As the viral load, CD4 count and symptoms are monitored, it may become apparent at some point that there is a need for a change in therapy. Since the goal of treatment is to lower the viral load to the lowest possible point, increases in the viral load measurement signal an increase in viral activity. One cause of this increase can be due to noncompliance. However, even children who have had good compliance with therapy can have a virus that becomes resistant to current medication. This resistance occurs because the virus can change or mutate. It is important to understand that antiretroviral medications can decrease the amount of virus in the body but they can never completely get rid of all the virus in the body. The HIV will find refuge in sanctuary sites or hiding places in the body, such as the solid organs of the body like lymph nodes and other places. The virus that is present in the body will continue to multiply. The less virus that is around, the less quickly the virus can multiply and mutate. Therefore, the goal of treatment must be to keep the viral load as low as possible.

Medications work differently in each person. The medication's ability to be absorbed and metabolized by the blood stream can affect its ability to fight the virus. In evaluating the medication's effectiveness, the medical team will be looking at trends in the viral load and CD4 count. One single set of labs should never be used in determining treatment decisions. A blood test called genotyping will be done to help determine the treatment course. Genotyping can test for viral mutations. It gives information regarding which medications are showing resistance to the virus.

[Keywords:HIV]

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