|Re resistance testing in treatment naive
Aug 12, 2006
I discussed your suggestion to get resistance testing now, before meds. My HIV MD and her PA in a NY state university setting both say they do not test before meds unless the patient is pregnant or recently seroconverted. She stated that testing now without the pressure of meds would mean the test would likely only show the wild type virus not any resistant strains. She claims that the current guidlines do not recomment testing now. She said she would do it if I insisted if my VL was greater than 1000. I'm not sure what to do at this point with such opposing views
Response from Dr. Sherer
Your doctor and her PA are citing outdated recommendations; both the 2006 HHS Guidelines and the most recent IAS Guidelines on Resistance recommend baseline resistance testing prior to treatment initiation in the United States for ALL HIV+ patients, not just those with recent seroconversion.
I advise you to insist on the performance of a genotype test before starting treatment, and to discuss this advice with your doctor and her PA.
In a US national CDC study of recently and chronically infected patients, 12% of recently infected patients and 9% of chronically infected patients had a mutation to at least one drug, and 2% had resistance to 2 or more drugs. There are similar data for patients in Western Europe. Hence your doctor is correct that the chances are good - 90% - that you have a wild type virus, and that all ART options are available to you. However, a 10% chance of resistance to one drug is a significant one, and both you and they would benefit from identifying such a mutation, if it exists, and basing your treatment on that information, as well as on other factors.
The links to the two guidelines mentioned above are noted below.
WHY NOT UNDETECTABLE
- Is There A Relation Between Homosexuality And Hiv?
- What Are The Best Condoms To Use To Protect Against Hiv?
- Chances Of Getting Hiv With Hangnail
- Will Chlamydia Show Up On A Urine Culture?
- What Pills Can You Take To Get Rid Of Bacterial Vaginosis Or A Yeast Infection?
- Syphilis Test Results
This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.
Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.