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When Will My Meds Fail Me?
Aug 20, 2009

G'day Doctors from way down here in Australia.

I am a 37 year old HIV positive male. I have been positive for the last 5 years.

I have been on Stocrin and Truvada (what you in the US call Atripla, but we don't have the one pill here, so have to take two, but same medication), for the last 14 months.

When I started, my CD4 count was 280, my CD4% was 22% and my viral load about 238,000.

My last results, just returned today are: CD4: 940, CD4%: 36% and VL: undetectable (<50).

I was undetectable after two months of treatment.

I have absolutely NO side-effects with the meds. I miss one dose in the last 14 months. Other than that, for me, it's like taking 2 vitamin pills before I go to bed. That's it. Simple and effective.

Obviously, my response has been great, and my specialist (and I) are very happy with the progess.

But I would like to know.... is there a period in the future when my medications will fail and resistance set in? Is that guaranteed to happen? Is this virus so clever that it will eventually outwit and outsmart the medications and come back?

Every time I check my blood (every 3 months) I am scared that the virus is going to become detectable again, but so far, touch wood, it's all good.

Will it get to a point where I can't take this medication anymore? What does the future hold for me in terms of medication if and when my current medication stops working?

*IF* these fail, is dying a slow, agonising death a certainty?

Please try and reassure me what the future holds! I know that HAART is relatively new, but are there signs that even though current medications are so effective, there will come a time when resistance is inevitable?

Thanks for all your good work. Boy from Oz!

Response from Dr. Young

Hello Boy from Oz.

Thanks for your post from down-under.

With your viral responses and excellent (really) adherence, there's little reason to expect that you should have treatment failure or drug resistance. Save for the very uncommon issue of super infection with a drug resistant strain, loss of medications or deterioration in your adherence, I'd expect your first line treatment to work for many, many decades.

I hope this helps, BY



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