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HIV Drug ResistanceHIV Drug Resistance
           
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Need help for a dear friend
Jun 11, 2001

My friend has a strain of hiv that is resistant to a medicine called sustiva, and some resistance to some type of inhibitor.

The problem is she is talking about ending her life or just stop trying any other drugs. I want to help her but she won't tell me much about her disease.

My questions are:

Does she possibly have some rare strain and therefore limited choices for medication?

What would cause this resistance?

Can you tell from what I've told you what strain she has?

I want to help, but don't have enough knowledge to look into ways to help her. I'm afraid if I don't do something she will just give up. Can you offer me any info????

Response from Dr. Little

The presence of resistance to a medication such as sustiva comes about when someone takes this medication (or occasionally one of the drugs in the same family of drugs) and the virus develops the ability to reproduce EVEN while the drug is still faithfully being taken. This generally occurs when the level of virus is not completely controlled (or suppressed) with a certain regimen (that contains the drug in question) and then some of the ongoing viral replication may give rise to a strain that is even better able to reproduce in the presence of the drug. This continues until ultimately, a drug resistant variant or strain becomes the predominant strain in the body. Typically, for people with drug resistant strains of the virus there ARE other treatment options - unless this is the latest in a long series of drug resistance mutations. If your friend has never taken HIV treatment, then the most likely explanation is that someone who was infected with a virus resistant to sustiva, passed this virus on to your friend (explaining how someone who has never taken therapy can possibly be resistant to one or more drugs). If your friend has taken HIV therapy, then I would guess that at some point she took sustiva or one of its related class of drugs and developed drug resistance as I described above. Without more information, I can only suggest that she discuss her test results with a physician with experience in the field of HIV drug resistance and see if alternative (often very effective) treatment recommendations can be devised. Unfortunately, resistance to sustiva is not uncommon - the bigger question is - is this the only drug to which she has detectable resistance??


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