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Infected in before HAART vs after
Oct 28, 2009

A friend told me it was better I was infected in the 2000's vs the 90's. I thought of course it is better, because there are newer drugs than what were available back then. However, that wasn't what he was talking about.

He said it made a difference when the person who infected me was infected, because the drugs the virus has been exposed to made a difference in how bad or weak the virus would be in me.

I didn't think much of it at the time, because I really didn't understand it. Does it make a difference when a person was infected and what drugs it has been exposed to and for how long? Does it make a difference whether I got infected by someone who got it in the 80's vs say 2002? Or, do you have no idea what my friend is talking about?

Thanks!

Response from Dr. McGowan

Thanks for your question.

I do have an idea about what your friend is saying. It is not a matter of how "strong" or "weak" the virus might be but what drug resistance mutations it may carry.

Since we weren't treating many people in the 80's and had no PIs or NNRTIs in the early 90s, virus that was spread in those days would be unlikely to carry drug resistance. Nowadays there is more treatment and more chance for virus to spread that already has some level of resistance. It depends on where you live -- areas like NY and SF may have higher rates of what we call "primary" or transmitted drug resistance. Overall about 15% of newly acquired HIV has some drug resistance. That is why we test the virus before we start meds to see what resistance might be there so we can choose the most active meds.

The downside about getting HIV in the early 80s and 90s is that, since we didn't have many strong meds around to get the virus undetectable, even though a person may not have acquired a resistant strain it would be easier for one to develop in the person because we couldn't prevent it with the meds even if they took all their meds on time.

Hope that is more clear.

Joe



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