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HIV Drug ResistanceHIV Drug Resistance
           
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Strange Genotype Results
Jan 17, 2000

I have been on HIV drugs for many years, having taken different combinations mostly centered around AZT, 3TC, ddI, Abacavir, Viramune and Crix. My VL recently started to increase, so I had a genotype test. The test showed plenty of Protease resistance, but did not note any NRTI/NNRTI resistance. Do you consider this a bad result, or can this be valid. Based on these results, my doctor changed me to Amprenavir, Sustiva, Abacavir and 3TC. I'm concerned about this and not sure if we're proceeding in the best way. What do you think?

Response from Dr. Holodniy

There are a couple of possibilities. There indeed is no resistance to NRTI/NNRTIs (possible, but unlikely, if previous regimens have failed), or resistance did develop, but you have been off these drugs long enough, the resistant strains have faded to the background and resistance tests are not sensitive enough to pick up these minority species now. We have clearly seen this fading effect, which makes the interpretation of resistance tests difficult, heavy previous drug exposure. The regimen choice is reasonable, given the resistance report. MH


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