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speaking of resistance
May 13, 2006

If a resistant strain is contracted at the time of initial infection but meds are not needed for years due to good labs can the virus mutate and become less resistant with time or will it always have the same resistance (off meds).

Should a treatment naive person be tested for genotype as soon as there's enough VL to do the test so they will know, when the time comes to start meds, which family of drugs to expect to be taking?

Response from Dr. Young

Thanks for your post.

In general terms, patients who have acquired drug resistant virus retain this virus for their lifetime. Back mutation to a less resistant strain can occur, but this is primarily an issue for resistance testing rather than whether or not drug resistance will remain a problem for the person.

As I've posted earlier, the most current US Department of Health and Human Services treatment guidelines strongly recommend drug resistance testing (probably genotypic) for all therapy naive persons. These tests require a viral load that is greater than 500-1000 copies/mL.

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