October #64 : Too Much Information

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Table of Contents

Stephen Gendin

Be Very Afraid

The CD4 Solution?

The Boys in the Band

Bare Witness

The March

My, What a Big Trial IL-2 Has! Will It Work?

AIDSplotation or Art?

Refugee All-Stars

Drive-By Shopping

Upward Mobility

S.O.S

NEG/POS

Take Five

POZ Picks

The Medium Is The Message

A Conference Of Their Own

Milestones

Cutting Class

Last Word

It Takes A Village Voice

Conference of the Century

Stop and Start

Sit Up, Sit Down?

Too Much Information

Sex RX

Talking Tipranavir

Shelf Life

The In Crowd

Herb Of The Month

He Died Of Old AIDS

10.8.88: Old Flames



Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV


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October 2000

Too Much Information

Do blips on the viral radar screen mean you should (A) switch your medications—and maybe run through the available drug combinations faster—or (B) try super-toxic-mega-HAART? No, it’s (C) neither, according to new research. Recent emphases on getting and keeping undetectable viral loads to prevent drug failure has led many doctors to automatically change HAART protocols in response to any viral load uptick at all. Now that second generation tests with a lower limit of 50 viral copies are common even a result between 50 and 400 (the limit of the older tests) has often caused major drama, leading to stopping old drugs and stating new. But chill out! In a large HIV practice in Washington, DC, doctors followed 32 HIVers who had been undetectable (less than 50 copies on two separate measurements) in the previous four months and then had viral blips between 50 and 400. With no treatment change, three out of four (24 patients) returned to undetectable, all but two of those by the next month’s test. “There’s too much faith in these tests,” says senior researcher Doug Ward, MD, “and people are too quick to change what is probably a successful treatment. I don’t even tell people to return for an early retest when I see blips. We just check at the regularly scheduled three-month intervals, and three out of four will be back below detection.” The bottom line: The most appropriate response to a low-grade blip may be response at all, unless a follow up reading shows that the viral increase is continuing.



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