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HIV Drug ResistanceHIV Drug Resistance
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Total resistance equals total frustration
May 21, 2002

More than 1 geno and pheonotype tests have rendered this long time survivor totally resistant to every drug. Presently T-cells at 60 and V.L. at 170,000, which it has been since VL testing became available, though I am relatively healthy and have been for many years. My biggest problems are with side effects, and I think I have discovered that PI's make me particularly ill, eg. severe dizzyness which can last for days, and nausea. I have dicided to take an "easy" coctail- Zeret, Epivir, Rescriptor and Viriad. Only major side effect seems to be constipation. My question is is there any use in taking these toxic drugs when I know technically they don't work? My numbers basically remain the same regardless of the regimine. Can you reccomend another "easy" med to add to my coctail? Am I the only person out there with such a high VL? Why am I doing so "well" despite terrible labs? Any advice would be welcome to compliment my own competent but frustrated MD. Thanks!

Response from Dr. Little

You are not alone - there are unfortunately many people who have developed significant drug resistance over time - including more than a handfull who continue to feel well, despite their apparently high viral loads. I can only say that there is quite a bit of data to suggest that treatment does prolong survival - even non-suppressive therapy. The task is to find the most potent, most tolerable regimen that can be taken in this situation. In general, I do try to find this regimen, since I do believe that even with a viral load of >100,000 you may be benefiting from therapy. The choice of what to take will require a long look at the relative resitance you have for the various drugs and the side effect profile of the same drugs. This is not an easy selection for any physician - and frequently requires a bit of trial and error on your part until you find a regimen that is tolerable and seems like there may be some effect on your viral load.

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