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recently diagnosed..., no need a genotype???

Oct 4, 2009

Hi Docs, first I want to thank you all your effort to help us to go through this condition. I have been diagnosed 4 months ago, infected 8 months ago max. my numbers cd4 around 550, cv from 10000 to 26000. My doctor told me that i dont need to start with the treatment and no need of a genotype because he use truvada + stocrin for all his patients and they do very well with this combo. What should I do? I am very worried- I dont care if i need to start the treatment now, as long as it helps me to control the infection the best way possible. Should I start the treatment or is it better to wait??? until when??? Should I get a genotype?? THANK YOU VERY MUCH for your help

Response from Dr. Young

Hello and thanks for your post.

HIV drug resistance testing (genotype and/or phenotype) is recommended for all persons initiating care (or treatment) by US and European treatment guidelines.

Since you mention Stocrin, I can safely assume that you don't live in the US, but you don't say what country you live in-- nevertheless, in most developed countries, the rate of transmitted drug resistance among treatment naive persons is approximately 10%. Failure to recognize this resistance in persons starting treatment very much increases the risk of treatment failure if you should be starting on a medication that your virus is already resistant to.

I agree with your doctor's opinion that it might not be necessary to start treatment immediately, but his reluctance to evaluate for baseline resistance seems out of place. Current trends are indeed to start treatment as CD4s approach somewhere between 350 and 500- so there's no rush. I'd try to find out what the published rates of drug resistance are in your region. This information could inform your doctor about your (and others') care.

Best of health to you, BY

viral load and t cell count
HIV/HSV2 treatment adherence

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