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worried about resistance all the time
Jun 22, 2012

hi mr young i am hiv positive since 2010, on atripla for almost 2 yrs. what scares me is i might deveope resistance soon and have to switch to stronger medicines, and number of pills will increase, side effects will increase, and cost will increase too, and one day i might run out of options. in last two years, i have twice herpes flair, once severe and once mild. and once i contacted bacterial infection through sexula contact, and every time i have to go for test i am scared to death as if results will come out to be bad, my cells will crash, viral load will increase, though till now, fingures crossed things have been fine, i am undetectable, and cds stable. but i read more and more that immune activation should be avoided, i do the best i can do, never had cold cough fever in last 4 yrs, but wot should i do with my fears. i really dont have much money to buy expensive drugs, and i am from india, so we dun have much generics too.

Response from Dr. Young

Hello and thanks for posting from India.

I suspect that you're overthinking this. If you've been successfully suppressed on your Atripla for two years, the likelihood that you're going to have treatment failure is vanishingly low. That track record of undetectability is living proof that the medication is effective against your virus, that your adherence is excellent (or at least more than good enough) and that the supply chain of medications (doctor, pharmacist, payor, transportation) has been very reliable.

I don't think that you need to be overly concerned therefore, about needing to go onto other regimens anytime in the near future; though that future is likely to bring us additional well tolerated and low pill burden regimens.

Immune activation is generally something to avoid, but this topic appears to not to be related to the issue of viral suppression and emergence of HIV drug resistance.

Indeed, at this juncture, with that long-term viral suppression in hand, I'd be directing my health efforts towards the more (and sometimes) more challenging issues of general preventative health- diet, exercise, tobacco and so on.

I hope that's a helpful discussion for you, BY



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