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The participation of Dr. Renslow Sherer in this Forum is made possible in part by an unrestricted educational grant from Abbott Laboratories.

Ask the Experts about Drug Resistance and Staying Undetectable
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Does Mutations mean Resistant?
Mar 30, 2006

Does having mutations mean that you are resistant or does it mean resistant to a certain level? My Geno type showed 3 mutations but my Doc said he was not worried about the three mutations. Does this mean I am resistant or resistant to a certain level? If so what does the Doc to to compensate for those mutation? Thank you

Response from Dr. Sherer

Good question, and one to write down and take to your doctor for your next visit, as he or she is the best one to answer your qeustion based on the specific mutations that you have, the regimen that you are taking, your recent adherence and viral load and CD4 cell counts, adverse drugs reactions, and a lot of other information that I lack.

Still, based on your doctor's answer, I am guessing that your genotype showed real mutations, but ones that are not associated (neither individually or as a group of 3) with decreased susceptibility to any regimen or single drug. These are often called polymorphisms or secondary mutations. I would caution you and your doctor that while we have seen little evidence to date that these polymorphisms contribute to phenotypic reduced susceptibility to a drug or a regimen, or to regimen failure, we are still learning about their role.

So your question is a good one because your have mutations which are not associated with resistance (apparently), showing that not all mutations lead to resistance.

If you did have resistance, your doctor would choose a new regimen which he would expect to have suppressive activity against the resistant virus.

In the meantime, your job remains to keep up the best possible adherence to your regimen, and to ask the same question to your doctor with these comments as well.



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