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HIV Drug ResistanceHIV Drug Resistance
           
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Is it too late?
Sep 6, 2001

Dr. Little, My brother in law was diagnosed with AIDS last year. He was in the hospital for about a month fighting for his life because of P.C.P. His viral load has been up and down. and cd4's rose from 10 to 154 over the past year. His current viral load is 30,000. Rose in a month from 6,000. My question is this....Is it too late for the "resistance" test. His Doctor never did one, even after we asked her to. I am concerned for him, as well as everyone else in our close family. Can you shed some light? Thank you so much! Jennifer

Response from Dr. Little

You have not mentioned whether your brother in law ever received antiretroviral therapy - if he has, then there is almost certainly a role for resistance testing if he is still taking medications and his viral load is rising. I will assume given the significant increase in his CD4 cell count from 10 to 154, that he did take therapy during the last year. If this is the case and his viral load is now rising, then it does seem like drug resistance testing would be useful. It is rarely too late for drug resistance testing to be performed since useul information is almost always identified.

If he is not taking medications now and never has, then the yield is lower (not zero), but may be less important that starting on something rather than nothing. I will typically order a resistance test on my patients who have not received prior antiretroviral therapy, but this is not standard practice.


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