Aug 20, 2002
My latest lab report contained info from a genotype test. It showed that there was some resistance to two of my current drugs: Rescriptor and Epivir as well as to protease inhibitors. However, my viral load is undetectable. My doctor wants me to continue with Zerit but add Viread. My chat with him left me wondering if I really should change-- or wait until I am out of the undetectable range. how reliable is the genotype test?
| Response from Dr. Boyle
The genotype is pretty reliable, but it is generllay not obtained in patients with an undetectable viral load and usually requires a viral load of between 500-1000 copies/mL to obtain a result. What you report is certainly curious from many angles, and I would discuss with your doctor why the test was ordered and what he planned on doing with the results. If the test is accurate, I would not add on a single drug to the regimen (which I presume is Rescriptor, Epivir and Zerit) since if it hasn't failed yet, it's going to and it may drag the new drug down with it. I would also consider rechecking the genotype, if that's possible, but would not do a phenotype since the mutations associated with Epivir and Rescriptor resistance are very reliable at predicting Phenotypic resistance and that is only likely to confuse things further.
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