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IS RESISTENCE LIKELY
Sep 19, 2006

I started meds in March 06 with CD4 136 VL >100,000. My Dr actually believed the true figure to be many millions. We agreed on Sustiva/Truvda combination - I have very few side effects. I am also 100% adherent, don't smoke, drink only occasionally and live in the UK and have access to some brilliant medical staff. I had developed KS but after 3 months on meds it began to reduce and disappear in some parts. I also lost 3 stone in weight. My numbers at the 26 week stage finally reached <50 with a CD4 340 and my weight is back to normal and I feel fine.

I have 2 questions. The first is because of my late and text book "AIDS" diagnosis i.e. KS, low cd4 will this likely effect my life span. I know the generally thinking is for a normal life span, have I missed the opportunity because I allowed my situation to get so bad or should the fact I live in a developed Country, have access to excellent medical care and look after myself outweigh that.

My second question is because it took the full 26 weeks to reach <50 will this effect the chances of becoming resistent to my current regime.

Thanks for your time.

Response from Dr. Wohl

These are great and understandable questions.

No one can say whether HIV will absolutely reduce your life expectancy. Certainly, it is a challenge to your health but, as you write, the developments of the recent past and those that await us in the future - not to mention your excellent care of yourself - makes me optimistic that you will get gray hair and grow old so that you can die of something more run of the mill.

There is little data to suggest a somewhat slower decline in your viral load will cause you any resistance problems later on. You had a high virus level and it took a while to decay to undetectable. I doubt you developed new resistance and as long as you keep your virus from making more of itself (with continued HIV therapy) the chance of new resistance is low. Even if you do see you virus pop up in a few years, there are great meds you can switch to to put the virus back in its bottle.

My bet is you will do fine.

DW



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