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Drug resitance testing

May 4, 2009

Dear Drs,

I want to start meds in the coming months(CD4s are dropping to lower 400s). I asked my health care provider if I could do asecond resistance test before choosing my first regimen. She, however, told me that by now (I am POZ for more than a year now) they cannot determine any resistance anymore. Such test was performed a year ago (shortly after being diagnosed) and seemed OK at the time. My main worry is however, that in the last year I have run into some risk of a new infection (And Yes, I am terribly ashamed about that). Could you perhaps explain to me why resistance testing is no longer possible a year after being infected? I fail to understand this.

Kind regards to you and the rest of the team from The Netherlands

Response from Dr. Young

Hello and thanks for your post from Holland.

I believe that your healthcare provider may be mistaken on two points- first, drug resistance mutations are now thought to persist for many months, if not years after initial infection. Hence, if an initial resistance test was not performed during recent or acute infection, a test later in the natural course of HIV could still detect mutations.

Second, if you had a possible reexposure and superinfection risk, it's entirely possible that you could now harbor resistant virus. While in absolute terms, this risk is low, if you were my patient here in the US, I could see ample reason to retest your your virus(es) resistance pattern.

Be well, BY

Night sweats
penicillin 2.4 megaunits tpha positive

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