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Resistence Testing
Sep 13, 2009

I live in a pretty remote area of NZ, and apparently contracted HIV through a transfusion in the States in '83, but wasn't diagnosed w/ HIV (AIDS really) until I was diagnosed with Stage IV Non-Hodgkin's Lymphoma (2008)(in remission after chemo, mono-clonal antibody treatment) My Dr. is good and kind (can you believe 3 Dr.s refused to treat me when I had the AIDS diagnosis in this day and age?) he put me on what you would call Atripla in America, the 3 drug cocktail. But he never ran the resistence tests I'm reading about here ... So, I should ask for a resistence test .... what do they call it in medicalese? What other tests should I get? My Dr. is always good about the 3 mo. viral load test, and the T cell monitoring, and hepatic panels, and WBC/CBC w/ platelet differentials. He's really a cardiologist though, and I just want to cover all bases so to speak. What are any other tests an AIDS patient should get done, and their frequency. Thank you very much!

Response from Dr. Holodniy

A resistance test determines whether your virus strain is resistant to HIV drugs. They come in 2 basic flavors, genotypic (looks at the genetic sequence of the virus to see if the mutations that confer drug resistance are present); and phenotypic which looks at how well your virus grows in the presence of HIV drugs. The former is significantly less expensive than the latter and yields about the same level of information, although might be harder to interpret for the inexperienced. The test usually requires a viral load of > 1,000 copies/mL. Given when you were infected, and if you weren't in contact with other HIV infected people, where you might have received a drug resistant strain, it is very unlikely you have resistance to those 3 drugs. The best time to have done it was prior to starting treatment. However, if you viral load is not undetectable and you are adherent to your regimen, it may be a good time to check for resistance.



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