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A warning about resistance and staying undetectable
Mar 6, 2005

This is not so much a question, but my own experience I hit the virus hard, went from VL of over a million, and CD4 count of 160, to undetectable and 650, kept it that way for a couple of years with Combivir (AZT 3TC) and Efavirenz/Stocrin I was going so well that I decided to have a break from treatment, and became ill in three months From a simple regime, I had to go onto PI drugs, gave myself several spells in hospital with pancreatitis from bad reactions to drugs It has taken me a year to get back to where I was, only today did I hear that magic word "undetectable" again, but for my trouble, Ive had a year of hell, and Im now on a much more rugged course of drugs than I was previously If you must take a break, monitor things closely, be prepared to restart quickly, and realise that regaining ground can be a hard path, hard if not impossible

Response from Dr. Sherer

Thank you for this important story: I agree with this message. In particular, a percent of patients will have recurrence of symptoms of HIV infection when they stop medications, in which case it is appropriate to go right back on the same regimen that you were taking before stopping. In most cases, the same regimen will work...but we are seeing reports of resistance to prior regimens, particularly the NNRTIs such as efavirenz and nevirapine, of 10-30% following treatment interruption.


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