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Lab results--genotype and cholseterol
Oct 17, 2003

Hi Dr Young!

Have not written for a least a day. I finally got my resistance test back. (one doctor forgot to order it, hence the delay). I was diagnosed 3-2003 (neg 3-2002). Aug 28 labs: tcells 250, vl 200K. Began kaletra, viread and emtriva 9/22. Resist. test 9/20. I received test back by fax today per my request as next DR appt is 2 weeks away. Was shaking when I read it. Not real sure what it all means. It lists many types of drugs under three general headings, e.g, NRTI, NNRTI and PI and says "sensitive" next to each in far right column. Under "Mutations Detected" it say "none" under NRTI, NNRTI's, but lists some mutations under PI's, eg. M361, M351 (? hard to read the fax) and L63P. Most relevant to me now, it lists L63P under Kaletra. What does all this mean?

Also got my cholsterol test back. I had insisted on one after learning about lipid problems associated with kaletra (dr never explained). My dr thought it was OK to wait until 6 weeks on meds. I insisted and it was taken 10/9/03 (about 2-3 weeks after beginning meds). Total cholesterol is 168, trigyycerides at 202, HDL at 38. LDL calculated at 90, VLDL calculated at 40.4 and Chols/HDL ratios at 4.42. Can you help me on this one too--what does it mean? Thanks, I owe you big time!

Kevin

Response from Dr. Young

Kevin- good to hear from you.

Your resistance test reveals good things- namely that your virus should be fully susceptible ("sensitive") to the medications that you're taking. The mutations that are looked for refer to genetic changes in the virus that can be associated with loss of potentcy (susceptibility) to the drugs.

Different mutations mean different things to different drugs; the mutation that they report, L63P is a change in the virus protease gene that is not thought to be of any real significance, but seen in some persons taking Kaletra (lopinavir/ritonavir).

As for your cholesterol tests-- they look fine. Your total cholesterol, and HDL cholesterol are fine; triglycerides slightly elevated (something that we see in PWAs all the time) and not too bad. Overall, nothing to be concerned about and it's good to have a baseline set of tests (actually part of treatment guidelines).

Nothing to owe, just keep up with the adherence, and let us know how your doing from time to time.

Thanks for reading. BY


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