how long can i be on treatment
Apr 1, 2005
Hello Doctor I am so curious why people are still dying do to hiv. If someone starts with above 200 t cells and doesn't haven't previous resistance, is adherent, and takes general care of themselves, why can't they survive. Also if someone were to start fuzeon today with an optimized backbone is it likely that they will in the near future be able to start taking this drug. What is the general medium of how long a combo lasts and what is the general amount of different combos a person can take. Hiv theropy seems to me if planned out correctly from the begining the patient should always be one alternative ahead of the pipeline. If i am naive please explain. I am starting theropy treatment naive in 2 months, t's are 325 and vl 38,000. I am a 25 yr old female and want to plan for my future, is their hope are we being lied to. Would love your insight. Stefanie
Response from Dr. Young
Stefanie- Thanks for your post.
I hope that you haven't been lied to about your prognosis.
The survival of persons with HIV has been dramatically enhanced-- so much so, that in recent studies, the causes of mortality (death) among persons in the US with AIDS has changed from HIV/AIDS-related to other non-AIDS causes, such as cancer, stroke, heart and liver disease or suicide. This suggests to me that so long as we have access to medical care and medications, that we can have a meaningful change in the major health threats to persons living with HIV.
Unfortunately some patients received non-suppressive treatments in the past, like single or two-drug NRTI regimens, generating early drug resistance and compromising the effectiveness of subsequent treatment. This was especially true when a single new drug was added to the failing treatment- rapidly causing failure of the new drug. This misadventure probably resulted in the premature generation of difficult to treat virus in these individuals.
As to how long medications can work; assuming that one starts with wild type virus (no drug resistance) and that the person is able to optimally take medications, I think that HAART treatment can work for a very, very long time. I have patients who have not had treatment failure or drug resistance after 8 years. So, first line treatments can be very sucessful. (Parenthetically, I would not recommend using enfuvirtide (T20, Fuzeon) as first line treatment, because of the cost and difficulty in administration.)
Even in the case of drug resistance or first-line treatment failure, we have very good treatments that can suppress the virus. Sucessful second- and even third-line treatments can be projected for most patients in these situations.
I hope that you find this helpful. BY
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