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Is there resistance?
Jan 21, 2002

Dr. Little,

I have been on EVR, 3TC, and Zerit for over 2 yrs. I was undectectable for most of that time. However, about 6 mos ago VL 1800 then 3 mos later about 1600. MY CD4 are around 900. Just 2 weeks ago my Dr. suggested replacing the Zerit with Viread because of lipodystrophy and detectable VL. The Viread does have side-effects though. DOes this sound like a good approach to you. Thank-You.

Response from Dr. Little

Actually, my approach would be to obtain a resistance test. If I had to guess, I would be most worried about resistance to sustiva (efavirenz) and/or 3TC and would therefore be very worried about simply adding tenofivir. If you have isolated resistance to 3TC, this might be a good approach given your high CD4, but I would not feel comfortable making this choice without a resistance test. The side effects of Tenofivir have been really quite limited in clinical trials - which is never a guarentee for you, but this drug is better tolerated than many. Good Luck.


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