If your treatment doesn’t work
Your viral load is the best way to know whether your HIV treatment is working. If your treatment is successful, your viral load should drop to an undetectable level and stay there. If your viral load remains detectable six months after starting HIV treatment, this may mean that your treatment is not working. Or, if you’ve been on treatment for a while with an undetectable viral load and then your viral load becomes detectable and stays that way, it’s likely that your treatment has stopped working.
You and your doctor will have to find out why your treatment isn’t working. The most common reason, though not the only one, is that too many doses are being missed. You will also need to know whether your virus has developed resistance to one or more of the drugs you are taking.
Resistance tests can detect changes in the virus and predict which drugs are most likely to work for you.
If these tests show that you have drug-resistant virus, you and your doctor will need to pick a new combination, one that has the highest chance of controlling the virus in your body. For your next combination to be effective, you will need to identify which drugs are no longer working and replace them with drugs that will work against the virus. Ideally, the new combination should contain three fully effective drugs. Your doctor’s expertise in these situations is crucial.