C.M. dear CM - based on what you write, there is little benefit to this combination anymore. The viral load is back to where it was at the beginning. The CD4 count is no better than before the medications. So it certainly would be time to do something. The question is what to do.
First question is to figure out what went wrong.
If this was the first combination, then it sounds potent enough to have controlled even this level of viral load. So something happened here that usually would not happen if everything was set. Perhaps they had trouble taking the combination and the rebound is due to not taking them correctly, or at all. It is pretty surprising if there was a good reason to use this combination that the viral load would be completely back to baseline in just four to five months. Resistance to the combination you describe just doesn't usually happen that fast or completely if the HIV was sensitive to the meds to begin with, and the person takes the meds.