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HIV Drug ResistanceHIV Drug Resistance
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Apr 3, 2005

Hello. I tested positive back in January 2003 (infected in December 2002). My last tests showed a decline to the point where my doctor suggested I considering therapy in the next 6 months. CD @ 350 VL @ 21,800) I just received a call from the doctors office asking me to come in regarding the results of my genome test. The doctor never said anything in my last vist (last month) that I would need to see him before my next visit in May. Now I'm very worried that he's calling me in to tell me I'm drug resistant. How common is it to find someone completely or almost completely drug resistant even though they've never been treated for HIV? Please respond ASAP - my appointment is in a few days and I'm dying with anxiety. Thank you.

Response from Dr. Sherer

The good news is that its unusual for a patient who has never received HAART to have multidrug resistance. However, it does happen. In a recent survey from the CDC in 2003, 14% people with chronic infection had resistance to at least one drug, and 3.1% had resistance to more than 2 drugs. This is not the same as being "completely drug resistant,", but it does underscore the need for a genotype prior to starting therapy in regions where the prevalence of resistance is 5% or greater. So your doctor is practicing good HIV medicine.

The fact that he or she is calling you to talk about the result doesn't necessarily mean anything - you'll find out when you get there. Most importantly, the doctor has followed the current standard of care in the process of taking care of you. This is a good thing. It would have been worse to start on a regimen that you might not have been fully susceptible to.

So, in sum: This is highly unlikely to be news that you are "completely resistant to everything." More likely there is something you need to know...not necessarily bad. As above, there is a small chance resistance to one or more drugs, in which case you want to know that, in order to get started on the best possible regimen for you.

Talk to your doctor about these concerns...and pay paticular attention to those actions that you can follow to get the greatest benefit out of your treatment.

Still don't understand resistance risk
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