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Re:How long we can alive in second line treatment
Jan 3, 2013

hello, i am a regular reader of this forum and found this question puzzling. first of all, Dr Young is absolutely right that second line can work for many many years, probably for 2 decades in some cases based on more than 95% adherence and avoidance of antacids(i hope i am not overestimating Dr BY!) then patient will go for next regimens based on isentress / maraviroc(based on tropism) or secong gen PI like darunavir. also there is good news about ibalizumab and many others (eg: some therapeutic vaccines) in the panel. so, dear friend, u still have to enjoy life for long long decades. but one thing i cant understand, why ur first regimen failed in just 3 years and 3 months? generally it should work for decades as well if adherence is >95%. Make sure that the reasons for ur switch is strong enough and discuss the case with expert like Dr BY and also please let us know as well. Dr BY, please tell me if i am wrong. anyway, a wonderful new year i wish for u all. voracious reader.

Response from Dr. Young

Hi Voracious Reader and thanks for sharing your thoughts.

To your question- sometimes people have regimen "failure" not because of drug resistance (or poor adherence), but because of side effects or toxicity. It's not clear from our previous poster as to the basis of the failure. In the case of drug resistance, we'll occasionally see this creep up in patients who didn't have the recommended baseline drug resistance testing and may have been placed unknowingly on an inadequately potent regimen.

But, if the regimen is thoughtfully selected, monitored and adhered to, drug resistance and virological failure is indeed very rare.

Hope that helps. Happy and healthy new year to you, BY



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