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Resistance Shown to all drugs - time to add Fuzeon?
Sep 19, 2004

Tested HIV+ in 1985 (asypmtomatic). Started AZT 1984 and went through many HIV drugs. In 2000 stopped Crixivan & others (CD-4 229 & VL 13000) and started Kaletra & ziagen. Now my CD-4 is 291 and viral load is 16,000 (usually stayed around 7000). Due to the last phenosense test which showed resistance to all HIV meds - Dr has switched me to ziagen- viread- norvir- fortovase and wants to add Fuzeon. Is this the time to add Fuzeon or should I wait a while? Health has been pretty good but fatigue has been becoming a more significant issue this year. Am concerned that if I burn through this new regimen (with fuzeon) in two to five years (which is how long most therapies have worked on me) will there be anything left to try? Thanks for your ideas.

Response from Mr. Kurtyka

It looks like your last labs were CD4 291 and VL 16,000. If indeed your phenotype demonstrates resistance to all antiretroviral meds, I'm not so sure I'd jump at Fuzeon right now. It would be optimal to have at least two active drugs on board with Fuzeon as the 3rd. If you have high level resistance to all meds and you add Fuzeon to the mix, you're essentially on Fuzeon monotherapy and you risk developing resistance to it.

Many folks can maintain a decent CD4 count and low VL even on a regimen with significant resistance. It sounds like this is the case with you, so I'd consider watching you numbers closely, and assuming they stay in a low range and you don't have HIV-related symptoms, stay where you are and hold out for some additional meds to add to Fuzeon. Check out clinical studies in your area ... there are new agents that are believed to be active with resistance to current agents.


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