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Factors CAUSING RESISTANCE
Jul 22, 2003

Is resistance only or usually caysed by people missing doses? Or does also or often occur because the virus "learns" how to beat the drug? Does anyone know the statistics regarding what percentage of resistance develops from missed doses, and what percentage is due to virus "smarts" or other factors? Also, how many years on average does a drug work before resistance develops?

Response from Dr. Wohl

There are a bunch of reasons viral resistance develops including poor absorption, cellular mechanisms that pump drugs out of the cell, drug interactions, and, yes, sub-optimal adherence.

It seems that poor adherence is the leader of the pack as a cause of drug failure and resistance, although it is not always easy to detect some of the other culprits.

Most studies that have measured adherence have found sobering results, with less than ideal adherence being fairly common. Among those who do stay faithful to their regimen, long term (years) suppression of the virus is often observed.

If you take 99-100% of your doses and develop resistance, it was one of these other reasons or that you were unfortunate enough to acquire a virus that was already resistant to HIV meds. DW



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