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Re: Drugs
Aug 2, 2001

Thanks Dr Little:

You reference recent infection, and although my partner knows who infected him he states it was within a year to six months ago. Does this constitute recent infection? When they do resistance testing do they test all the drugs on the market and then use this information to create a regimen. I have one other question doctor. We are quite concerned with drug side effects...Since this is fairly recent, and his numbers are good (30K VL and 700CD4) if he went on a low level of meds would this fight the virus from progressing for a long time so he would not have to take a more potent regimen any time soon, if at all--thus, he would have a normal life not filled with numerous drug side effects? Your knowledge is invaluable and helping us with our decisions! Thanks a million

Response from Dr. Little

If your partner was infected within the last 6-12 months, this is generally considered recent infectin. I would definitely recommend resistance testing in this setting. The difficulty may be in proving "recent" infection if your partner does not have a negative antibody test within the last 12 months. If your partner does not have a documented negative HIV antibody test in the last 12 months, then you can ask about a "detuned" HIV-1 antibody test - they are not widely available, but if you live near a university hospital with an HIV clinic that has a focused interest in recent infection, they may be able to provide this test. However, this is all just for purposes of documentation and not really critical - your question was resistance testing - yes, they do all currently available drugs on the market.

Regarding your second question and the "low level of meds" - this is unfortunately not considered a good option. The use of antiretroviral medication has really turned into an all or none science during recent years. This may change with newer drugs or other interventions, but for now, it is generally recommended that someone take potent therapy or no therapy. I highly recommend that you do a lot of reading and talk with your physician or treatment counselor about side effects - they are not routinely disabling to all - rather most people with the appropriate counseling get over the initial exposure and more significant side effects during the first 2-3 weeks of therapy and then do quite well thereafter. The most important thing is that you have a relationship with a care provider you can talk to and discuss your concerns. It is a big step, but I would rather people make an educated decision to delay therapy only after they have all the facts - don't base this decision on fear. There are risks and benefits - you need to know both.


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