frequency of resistance
Nov 4, 2006
I get my first genotype testing in Dec, next appointment. Am a bit apprehensive, don't require meds yet but I know I eventually will.
I understand that 90% of virus out there is supposed to be wild type with no resistance. But with so many HIV patients out there on meds aren't a much higher percentage of resistant strains being passed on? If meds are working viral loads are UD and unlikely to be passed on. Those HIVers with detetable, higher levels are the ones more likely to pass on the virus and those strains are more likely to be resistant strains. Am I missing something?
Response from Dr. Young
Thank you for your post.
You're right in that many HIVers have drug resistant virus and have the potential to transmit the resistant strain to their sexual or drug partners. If the patient's medications are working, then there's much less risk of transmission of HIV, resistant or not; it's the patients who are either non-adherent with detectable virus, or those with multi-drug resistant ("unsuppressable") virus that are the likely culprits in resistance transmission.
Overall, in the US, about 10-15% of newly infected patients have some evidence of significant drug resistance. The rub is that in some regions, like San Francisco, the rates may be as high as 25% (that's 1 in 4 persons)-- not very good odds. Several recent studies show that transmitted resistance, if not recognized, is associated with a higher risk of treatment failure. For this reason it's a good thing (also recommended by US treatment guidelines) that you're doctor has requested resistance testing.
Here's hoping that you're in the 90% group.
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