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Returning to Sustiva
Mar 15, 2009

Hi Joseph, Thanks for your excellent answers to my previous post on Reyataz. I have found these forums to be really helpful in providing context and perspective on my own disease. Okay, to my question; when I was initially diagnosed with HIV, the shock (I always practised safe sex) was compounded by learning that I had primary resistance (M184V) AND a low T cell count (190). All of this info (and the fact I was loosing muscle bulk by the day) was too much, and (in August 08) I took an overdose of a WEEKS meds, which at the time where Sustiva, Tenofovir and Combivir... quite a selection! Although after intensive counselling I finally got my head together, there has been a nagging doubt since, that I might have jeapardised a sustained NRTI treatment response on my current regimen, ATV(r), TDF and Combivir, which was initiated 5 days after the overdose. Is this so, and could I ever go back to having Sustiva? Prior to the overdose I was treatment naive with a VL of 14,000. This was reduced to ud in just 3 weeks. I'm hoping the short delay of 5 days before initiating my current regimen prevented too much EFV monotherapy and the K103N mutation from developing, but I don't know. Thanks again, and although this question is a bit marginal I would appreciate a reply. Peace, M. ps. I would also like to say to others that with the right help and support you CAN re-build and get on top of HIV, although it doesn't feel like it at the time.

Response from Dr. McGowan

Dear M.

Thank you for your question and kind comments.

I am gald you have a more positive outlook on life now, that is an essential element in getting and staying well. Since your viral load was undetectable at the time of your brief treatment interruption it is rather unlikely that your virus would have had the time to reactivate and grow enough to have selected drug resistance during that 5 day washout. If needed you may be able to reuse Sustiva, but it would have to be combined with enough other active drugs (not affected by the M184V mutation) to support it. If you are doing well on your current regimen there would be no reason to switch.

Good luck, Joe



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