Jun 3, 2003
Dear Dr. Young:
I was diagnosed a couple of months ago as pos. I am going for my genotype and phenotype test later this month. I keep seeing on this site that people will probably do well if they do not have a drug resistant virus. Needless to say, I am about as petrified of the resistance test as I was of my hiv and lab tests. After years of neg tests and always using condoms, I am still in shick at the hiv test itself. Then I found out I have a high vl already. This genotype test feels like it could be the last straw! Anyway, if I have a drug resistant virus, what are my odds ? How long will I have? Just a rough estimate. Any studies on this yet? What are odds that new drugs will come out that will extend my life? Is a person with a drug resistant virus usually or often resistant to all or many of the meds out there? This last question is very important to me as I would be baffled if the virus was resistant to all or many of the meds. Why would that be?
Response from Dr. Young
I'd try to focus you attention on the point that there still (fortunately) are a minority of persons who acquire drug resistant virus. Fortunately, the nubmer of persons who acquire multi-drug resistance or multi-drug class resistance is lower still. These proportions varies from city to city and should definately reinforce the idea about safe sex for those who have HIV and are on treatment.
Yes, the best odds are for those with fully drug susceptible virus, but note as well, that there have been tremendous strides made in the treatment for persons who have drug resistant virus. Indeed, the sucess of second- and third-line HAART now approaches that for where we were for first-line HAART regimens only a few years ago.
There is an ongoing search for newer medications and newer classes of medications; one of the major objectives is to find drugs that can treat persons who do have multi-drug resistant virus.
The key thing at this point is to figure out if you need to be on treatment-- the reason to do the resistance test is to find out the best possible treatments to use, when that time comes for you.
Good luck. BY
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