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Drug Resistance
Jun 18, 2005

How long can u stay on the same meds? Are You likely to become drug resistance?

Response from Dr. Sherer

Drug resistance is common, and increasingly common over time, but there is debate and uncertainty as to whether the development of resistance is inevitable, particularly in a patient who has excellent adherence.

In a large cohort in London followed over 6 years, about one third of patients had regimen failure, and one quarter had drug resistance as a major contributor to regimen failure. The longest clinical trial with a majority of patients having excellent viral control and an average rise in CD4 cells is the Abbott 720 trial of lopinavir + stavudine + lamivudine, in which two thirds of patients were fully suppressed for six years. A three year follow up of patients in the Gilead 903 trail of efavirenz, tenofovir, and emtriva also showed that two thirds of patients were well controlled after 3 years. Many clinicians have patients who have done well for over 5 years on the same first regimen - this is the reason that so much emphasis is placed on getting ART right the first time it is used.

You can increase your chance of long term success on your first regimen by ensuring the best possible adherence to medications from the very first day you take medications.

Undectable but dropping CD4s
recent sero conversion and when to begin treatment

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