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Question on Resistance
Feb 5, 2004

Dear Doctors,

I have a question on the Kaletra/Combivir regimen. I was diagnosed last year with a 13 cd4 count and over 300,000 viral load. I was immediately put on the above regimen. It's been exactly one year since I've started this regimen and was wondering how long does it take for resistance to build to any of the medications on this particular HAART combo???? Also, do you think this was a wise combo to start on given my initial diagnosis. Thank you in advance for answering my quesiton!

Response from Dr. Sherer

Yes, I think this was a good initial choice for you. Kaletra and Combivir are listed among the preferred regimens for initial therapy in the HHS Guidelines.

In a study of a similar regimen of LPV/r (Kaletra) and D4T and 3TC (rather than AZT + 3TC, which is in combivir), patients like you with initial CD4 cell counts below 50 and viral loads above 100,000 did as well as those with higher CD4 cell counts and lower viral loads.

You could probably answer your own question better than I regarding how well you are doing. What has happened to your CD4 cell count and your viral loadin the last year? How do you feel? The answers to these questions are more important than the range of possible responses that I could describe.

Regarding how long it takes resistance to develop, that depends on a long list of factors, such as how regularly you take your medications, whether there was drug resistance at the time you started your medications, how well you have tolerated the regimen, and other factors. One advantage of the regimen you are on is that resistance to the protease class has not been seen when LPV/r is used in the initial regimen, and resistance to other drugs in the class occur infrequently.

magic johnson style hiv
Drug Resistance Development Possible?

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