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Generic vs. brand name causes rebound?
Apr 2, 2013

My son was diagnosed with HIV at age 1. He developed a resistance to one drug in his cocktail in the first year, and it was believed that his birth mother passed on a strain that was resistant to it. He's now 6 and has been on the same cocktail (kaletra, ziagen, and azt) for almost four years, and he's been undetectable since 2010. His last two viral loads were 254 and 1500. The only change has been a switch to generic for ziagen. Adherence is the same as always (above 95% standard). Could the switch have led to viral rebound? And why aren't his doctors prescribing something new? They told us to keep giving him his meds as prescribed until his appointment next month. Isn't it important to get his viral load back under control to avoid further mutation?

Response from Dr. Young

Hello and thanks for posting.

There's no particular reason to think that the switch from branded Ziagen to generic abacavir should be responsible for your son's increased viral load.

The first thing that should happen is an assessment for adherence (check); next to verify that there's no recent activation of the immune system from recent infection or colds; then a confirmatory viral load test with option to obtain a drug resistance test is the step that confirms if there's a problem with drug resistance and offers the care providers guidance about which drugs the virus remains sensitive to or not.

It is absolutely important to get the virus under control and undetectable- getting good information about the causes of the problem and best next treatment options are the steps to take now.

I hope that helps; please write back anytime. BY



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