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HIV Drug ResistanceHIV Drug Resistance
          
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resistance testing before starting drug therapy
Jan 1, 2002

I have just become aware that I am HIV +. My cd4 is 104 and viral load greater than 75000 copies. I dont have the exact VL due to the type of test. I have never been on therapy and I have never had symptoms related to HIV. I dont remember the doctor discussing a resistance test ? Is this a routine test before starting therapy ? Should I request a test ?

Response from Dr. Little

No one knows the answer to this question - so I will give you my opinion. Yes, I think that there is now sufficient data on the transmission of drug resistant virus and the persistence of some drug resistant mutations for several years such that I would now do this test before (or concurrent) to starting new therapy. This is a very controversial area at present and not all providers will agree. Clearly the finding of a drug resistant mutation or two is very helpful, though the finding of no resistance does not necessarily mean that there is not resistance present. Resistance can be present at such a low level that our available tests do not readily pick it up. But still, a positive test is so helpful, that I think I would recommend testing in this setting. As I said though - this is my opinion, and not necessarily the consensus of the health care community at present.


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