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HIV Drug ResistanceHIV Drug Resistance
           
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'accidental' treatment break
Oct 9, 2006

Hi I enjoy travelling extensively, but with increased airport security I am a little concerned about carrying meds in hand luggage, and figure that they are less likely to be 'discovered' or seen (by customs and some people who I travel with who don't know) in the main luggage that is checked in. However, there is always the chance that checked in luggage could get lost or delayed (though this has never happened to me in 15 yrs of travel) and therefore losing meds for duration of vacation. So my question; my VL is <50 copies and CD4 is in the region of 700's. If in the event of my suitcase getting lost or delayed and therefore being without meds for a few days or a week or two, am I putting myself at any significant risk? regards Mike

Response from Dr. Sherer

Checked luggage is at risk of being lost or delayed, so it makes the most sense to keep your medications with you in your hand luggage. Unless you are taking liquids, there should not be an issue with your pills, though you are correct that they may be examined, and thus your confidentiality may be compromised. And even if you are taking liguid formulations, the recent revised standards allows for small amounts of liquids.

Yes, you are at a small risk of developing resistance any time your medications are interrupted. The degree of risk varies to some extent with your regimen, in that interruptions more likely lead to resistance with the NNRTIs, eg with sustiva and viramune, that with the boosted protease inhibitors. The risk is small in any case, and smaller still if the medications are stopped as recommended by the HHS guidelines, i.e. the NRTIs are continued for a week after the NNRTI is stopped, or a boosted PI is substituted for the NNRTI for one week, but these strategies may not be avaialble to you if you have no medications at all.

I suggest that you talk to your doctor about all of these considerations. My own advice is that you should not abandon your travel plans due to this concern, and that most of the time, you and your meds arrive safely if they travel with you in your carry on luggage. The small loss of confidentiality to an airport security person who has no interest in your medical status seems of little consequence.


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