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HIV Drug ResistanceHIV Drug Resistance
          
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can the virus lose resistance?
Mar 16, 2004

after many years on drugs. The virus is resistant to many I can take. The remaining drugs I can take all induce heavy, live hindering side-effects, like suicidal depression or intestinal bleeding. I asked 2 doctors how long it would take for the virus to return to the "wild state." Once I stopped taking anti-virals. Dr. #1 said 3 months. Dr. #2 said up to 6 months. I was wondering what your take is on this. Once the viral suseptability has returned. I intend to return to treatment.

Response from Dr. Sherer

The two doctors have given you reasonable answers. So-called "reversion" to wild type can occur rapidly, i.e. within a week or so, or it can take longer, i.e 2-6 months. In one recent study from the CPCRA, the process occured in most patients in 2-4 months. More recently we have seen evidence of the persistence of resistance mutations for a year or more in a minority of patients.

"Reversion" is a misnomer, i.e. it is misleading, because rather than a virus changing back to wild type, what is happening is overgrowth of the wild type compared to the mutated virus.

Finally, I advise that you follow the strategy you described only with your doctor's consent. In several recent trials, the practice has been associated with outcomes that are poorer than outcomes in patients who remain on therapy. You have described difficulties with side effects, which may be an additional compelling reason to be off therapy.


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