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Missed 1 dose
Feb 21, 2005

Dear Dr. Young

My wife started treatment in Sep 2004 on AZT, 3TC, and Nevirapine with CD4 of 83, viral load of 2071, and CD4% of 12.8%. In Jan 2005, her CD4 was 133, CD4% of 20% and undetectable viral load. She has been 100% adherent, taking doses at 12-12.30 hrs. interval at 8-8.30 AM and PM. Last night, she forgot to take her dose and took it at 5.45 AM (ie late by 8 hrs). Is that likely to cause any major problem (she has been adherent for close to 300 doses over 5 months). We plan to reduce the time difference to 9-10 hours till the time we reach the earlier scheduled time. Will the late/missed dose of AZT, 3TC, and Nevirapine cause resistance to be built up.

Regards

Vineet

Response from Dr. Young

Vineet-

No need to worry- your wife has had exemplary adherence to her treatments. A single missed dose is not likely to cause any problems. The problem with missed doses is really one of multiple missed doses-- in these cases, there is an increased risk of developing drug resistance.

I'd just continue onward with the next dose.

Thanks for reading. Hope this helps. BY



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