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HIV Drug ResistanceHIV Drug Resistance
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time without meds
Jul 10, 2007

Are there any studies out regarding how long someone who is newly HIV infected typically goes before starting meds. I know this varies for everyone, but I'd like to keep my treatment options open and avoid toxicities as much as possible early on. thanks...

Response from Dr. Sherer

There is a wide spectrum of responses to HIV infection. About one third of patients are rapid progressors and may develop AIDS or serious illness within 3-5 years. More commonly, i.e. for the majority of people infected, the illness is more gradual and serious illness occurs after 10 years or more in the US and Europe. There is evidence that this natural history is different in other parts of the world, e.g. it may take only 5 years in Ukraine and Uganda. And finally, a very small percent, <1%, are 'long term non-progressors' who have no evidence of clinical illness for 15 years or more. Over time, it has appeared that even this group eventually develop AIDS and become ill.

But you should talk to your doctor about your situation, since it is more meaningful to understand where you are along this spectrum, based on your baseline CD4 cell count, viral load, and clinical situation, as well as the trends in your CD4 cell counts and viral loads over time, and the results of your baseline resistance test (if that is available to you and your doctor). This will present a clearer picture of your status, and you can refine your question to: "What usually happens to people like me, with my baseline viral load and CD4 cell count, resistance test results, and CD4/VL trends over time?"

drug resistance - when does it occur?
Go for undetectable at any cost?

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