|general question on resistance
Jan 11, 2003
This probably isn't as vital a question as you might normally answer but if you could clarify, I would find it helpful.
Reading through some of the questions and answers that many people have become "resistant" to HIV drugs. I was wondering why this happens.. for example, does the virus 'mutate' upon introduction of meds or does it change over a certain timespan/stage of the disease which then render the meds ineffective? Thus, if the virus mutates when meds are introduced how likely is it that a cure will be found if the virus is constantly producing new 'strands' of drug resistant sub types?
Response from Dr. Little
The virus undergoes changes or "mutations" with every round of the viral lifecycle - whether drugs are present or not. It is only that in the presence of antiretroviral drugs that are not potent enough to stop HIV replication, that some of these changes may by chance actually result in a survival advantage for the offspring virus that now carry the drug resistant mutations. It is by no means a given that any particular drug will fail after a period of time - drugs may last for years or decades (we don't yet know how long). It is clear however, that failure to take the medications as prescribed (or any cause of a low blood level of the antiretroviral medications) can result in the emergence of a drug resistant variant over time (the time will also vary depending upon the drug and the amount of viral replication). It is a fairly complicated topic and not one with a standard pattern.
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