Question
An 11 years old HIV infected boy on antiretroviral therapy {ART} consisting of Stavudine {d4T} 30 mg, Lamivudine {3TC} 150 mg and Nevirapine {NVP} 200 mg for the past 1 year was referred for further management. He had jaundice 1 year back and herpes zoster 1½ years back and had received antituberculous therapy {ATT} at 5 years of age in view of symptomatic mantoux positive. His CD4 count 1 year ago was 355 cells, cumm and HIV viral load was 248,776 copies, ml. On examination, weight was 28 kg, height was 135 cms. Other systems were normal. In view of improper doses of d4T, 3TC, NVP, the doses were adjusted and he was continued on the same. At age of 14 years, his viral load was undetectable and CD4 was 744 cells, cumm. At end of 15½ years, his viral load was 6192 copies, ml and CD4 was 600 cells, cumm.