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HIV Drug ResistanceHIV Drug Resistance
          
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Is my body just giving up?
Jun 6, 2001

Hi there doc. I have been POZ since 1989 and have been on every med combo there is. At this time my VL is 250,000 and TC is 67. It seems like the meds work for a while then all of a sudden they just stop doing their thing even though I don't miss a dose. My question is. Is my body just giving up? My doctor doesn't know what to do next to help get my counts to be better. Is there anything you can suggest that may help. Also my doc and done one of those resistance test and it seems like the only thing I can take now is Videx and Norvir but now it seems like that is also failing. Thank you for any help you can give.

Response from Dr. Little

Unfortunately, many people like yourself who have been infected for many years have received antiretroviral therapies as they became available - something we now call sequential monotherapy. This means that the drugs were never used as we now know in the best possible manner and even if you take every dose as prescribed you may still fail on the basis of pre-existing drug resistance mutations. To complicate things further, many people fail drugs like ddI (videx) without detectable resistance - we think this is because we have simply not identified all of the important changes in the virus that cause it to become resistant to this drug (d4T is similar). My best advice is to ensure that someone who is very familiar with drug resistance test interpretation review your test results (this may well be your current doctor if he/she is very experienced) and then try to come up with the best possible regimen. It is true that people that are unable to suppress their viral replication because of drug resistance, still have slower disease progression than people at the same disease stage who do not take therapy. I would also look into research study options in your area which might offer access to some of the investigational drugs which are thought to be of use in people with significant pre-existing drug resistance.


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