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Resistance testing 4 wks after starting meds
Jul 3, 2000

I live in San Francisco. I experienced the ARS in late 2/2000, first tested HIV+ on 5/1/00, and started 3TC, D4T, and Sustiva 5/5/00. My initial viral load was 120,000. I did some reading and at my next appointment asked my doctor to elect to do resistance testing (as I am newly infected). That was 4 weeks later, and at that time my viral load was 1,200.

I now understand that resistance testing should be done in my circumstance in a drug-naive patient. Will the results of the resistance testing be useful considering that I was taking meds for a month?

Thank you for your time.

Response from Dr. Holodniy

Although drug resistant virus exists in SF, the majority exists in people who have received treatment and not in those who are acutely infected. Usually we like to get the resistance test before treatment starts in people acutely infected. In those that are recently infected, the longer one waits before treatment, the harder it is to find any resistant virus, because a lot of resistant strains retreat to the background below detection limits of resistance assays in the absence of drug pressure. A resistance test might be indicated in your case if we didn't think you were responding appropriately to the regimen. For instance your viral load only went to 20-50,000 after one month of treatment. In your case, your response looks like someone with NONresistant virus. I am not sure you will find anything now.

MH



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