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Jun 27, 2010

dear doc after my hiv resistance test i have been found to have subtype AE and low level mutations towards NRTI i would like to know if atripla will work well for me if i adhere very well as it was prescribed to me by my doctor and i also would like to know how long on average before my treatment will fail due to virus mutations, thanks alot

Response from Dr. Young

Hello and thanks for your post.

I suppose the devil is in the details of your resistance pattern. However, since all of the components of Atripla (tenofovir, FTC and efavirenz) have relatively low genetic barriers to resistance, most experts tend to avoid the use of this combination in persons who have the potential for resistance to any one of the three components.

If you only have low-level predicted resistance, then it's possible to use Atripla, but again, it would depend on the degree of resistance.

Clearly, with any regimen, adherence is an important factor in success and failure, particularly among persons whose virus harbors drug resistance. It's difficult to predict time to failure (it's dependent on multiple factors, including the degree of initial resistance, type of drugs and type of non-adherence, to name a few), but most treatment failures tend to happen within the first several months of treatment, with lesser risk thereafter.

I hope this helps, BY

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