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re:Could my next labs show resistance?
Aug 29, 2010

Hi again thanks so much for your answer. I don't think I made myself clear. I understand your point about treatment forcing mutations to 'show themselves' and become dominant but I didn't mean mutations that existed before I started treatment.

If it takes, for example, 3 months to become undetectable is that because the virus is still replicating (and therefore new mutations and resistance could occur in that time) or is it just because there is so much HIV in the body before HAART that it can take a while to die off? I thought the life span of infected cells was a lot less than that so how could it take so long to get undetectable? Unless it was because it takes 3 months (e.g.) for the virus to become undetectable and therefore for resistance to become more remote.

Thanks again, I hope it's clear what I'm asking.

Response from Dr. Holodniy

The HIV treatment response is a complex interplay between the total virus burden and virus replication rate (and therefore rate at which copying errors and the potential for developing de novo resistance mutations occurs), replication and destruction rate of cells that are HIV infected; and rate, penetration, concentration and metabolism of HIV drugs in various cell types and tissues. All these combined, along with adherence levels by patients, to produce a result why it takes 3 months or more to achieve an undetectable viral load, or create a situation where resistance will develop.



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