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HIV Drug ResistanceHIV Drug Resistance
          
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once resistant to one drug,
Feb 22, 2004

Dear doctor, Is it trure that I will be resistant to one drug forever once I become resesitant to that drug? Thx

Response from Dr. Sherer

It may be more accurate to say that once you have developed a resistance mutation that is associated with resistance to one drug, you retain that mutation indefinitely.

There are cases where the amount of resistance with one mutation can be overcome, for example by increasing the exposure to the same drug with a higher dose.

Also, even if the mutation reduces the ability of the drug to lower the viral rate of replication (viral load), it may still provide enough benefit to be of use if used in combination with other active drugs. Thus that drug may still be of use in a future regime, even though your virus has reduced susceptibility to it.

Importantly, a genotype test may only detect that mutation (or those mutations) if you are still taking that drug, and thus the virus feels 'pressure' to maintain the mutation. If you are no longer on that drug, or one of like class, the mutation may not show up on a genotype test. But it is still there, 'archived' on a minority viral species, but always able to return if you are again put on that drug.


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