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Response from Dr. Sherer

A negative genotype test does not mean
that you have never taken any HIV meds.
It only means that there are no resistance
mutations in the majority (>20%) species
with which you are infected at this time
while on your current regimen.
More information would be needed to interpret
these results in your sitation. If, as you
suggest, you have always had >95% adherence
(congratulations, by the way, and keep up the
good work), and you achieved good viral load
suppression with all of them, then the genotype
may be accurate, and you may still have wild
type as your dominant species.
In that case, perhaps your regimens were changed
only due to toxicity, or to simplify your regimen.
However, this genotype may have failed to detect
an 'archived' mutation to one of your earlier
regimens. If so, re-exposure to the same drug, or to one
with cross-resistance with that drug, would then
cause that resistance mutation to re-emerge.
If, for example, your regimen sequence was
Crixivan plus nucs, followed by Sustiva plus
nucs, and then Kaletra plus nucs, you may have
an archived mutation to Sustiva which might
not appear on the genotype test if you are no longer taking it.
As always, I suggest you talk about these results
and what they mean with your doctor.
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