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HIV Drug ResistanceHIV Drug Resistance
          
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Resistance question
Jun 13, 2001

I was on a previous regimen containing Sustiva and after a few months my viral load began to climb back up. I then switched to a new regimen containing Nevirapine and have been on this for over two years now, and reached undetectable viral load as well. I had not expected such a good response from Nevirapine as I failed on Sustiva, is this normal as I had expected limited success as I had failed on one of the drugs from the same class.

Response from Dr. Little

You are correct in your surprise to be doing so well after "failing" sustiva. The major question is whether you failed on the basis of drug resistance of something else (ie tolerance, or inadequate duration of therapy). If you really did develop resistance mutations consistent with prior sustiva therapy, I would follow your course a bit more closely on nevirapine since I find your present response quite unusual. But, from the sounds of it, you are truely doing well and this is what makes generalizing about treatment recommendations so difficult - no one rule works for everyone, there are always exceptions. Lucky for you to be the good exception.


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