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HIV Drug ResistanceHIV Drug Resistance
           
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How long before resistance
Jan 24, 2005

How long can someone realistically expect to be on meds; sustiva and combivir before having to begin PIs. These are the physically altering meds, correct? My friend has been on the above meds and has not been very compliant; possibly 85% compliant.

Response from Dr. Sherer

In the longest trial of this regimen, in which 31 patients started on this regimen and were followed for 5 years, almost one half of patients were still controlled after 5 years. Your best chance of achieving good control for this duration or longer is to do your best to adhere to the drugs and not miss a single dose.

It is wrong to characterize PIs as 'physically altering meds', as you do. The most common abnormality associated with HIV medications is subcutaneous fat lipoatrophy of the face, arms, and legs, and this has been most strongly associated with D4T (stavudine) and DDI (didanosine or Videx), and AZT (zidovudine) to a lesser extent, which is part of combivir.

The PIs have been associated with odd fat changes such as central adiposity and the dorsocervical fat pad, but these conditions have also been described in untreated HIV positive patients, and patients on the NNRTIs as well. It appears that both the PIs and the NRTIs together may contribute to these conditions, as well as HIV itself, rather than a single drug class.


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