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Resistance test a must?
Feb 20, 2005

I've got my prescription and am ready to go. Or am I? Three months ago my labs were getting iffy and I was told to start getting ready to commence treatment if my labs this time were the same of worse. So they were worse. I asked my doctor as he was writing out my prescription if I shouldn't be getting a resistance test first. He said that the opinions on the necessity of this test varied and that he didnt believe the test to make any difference because Id be monitored closely during the beginning of treatment anyway and that until the strain prevalent in 99% of the cases hes seen (Amsterdam) is suppressed, the possibly resistant trains wouldnt show up in the test anyway. I am a little apprehensive about this answer, particularly because I was of the impression that it was a good idea to get a resistance test, and not only that, but that it was now pretty much standard for anyone starting treatment to get this test. I am leaving for a three week vacation to warmer climes this Wednesday and want to start as soon as I get back. My numbers went from CD4 300 to 250 and VL from 31000 to 18900 percentages went from 17% to 16%, I have no health issues whatsoever. Do you think I should delay starting treatment more than the three weeks I am already delaying it by insisting that when I get back I get a resistance test first? Or does my doctor have a point and should I just go ahead and start as soon as I come home? Thanks for your time and for this great forum, Eric.

Response from Dr. Pierone

If you acquired a resistant strain of HIV it should show up on standard resistance testing. Although I don't know the resistance rates for untreated patients in Amsterdam, is seems prudent to do a resistance test. The chance that it would show resistant virus is low, but if resistant virus is present, it does affect the success of initial therapy. Delaying therapy for a few weeks should pose no problems. Good luck.



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