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Adherence to Different Meds
May 31, 2010

I have consistently heard that patients must strive for an adherence level of 95% in order to avoid the risk of resistance. Is that adherence level applicable to all available meds or are there meds that require a higher level of adherence? I am on Truvada and Isentress and missed my first dose since starting treatment in Nov 2008 ever last night, thus the question.

Response from Dr. McGowan

Hello Thank you for your question. It is a good rule of thumb to maintain the same level of adherence to all HIV medications. Having said that some HIV drugs are more "forgiving" than other medications as they have a higher genetic barrier to resistance. This means that it takes a number of mutations before drug resistance is manifested. Whereas for some drugs, one or two mutations results in drug resistance. The fact that you missed one dose during this entire period and, assuming that your viral load is at undetectable levels, the likelihood that you may have compromised your regimen based on this minor lapse in adherence is extremely unlikely. Thanks Joe

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