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HIV Drug ResistanceHIV Drug Resistance
           
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Another Resistant to everything ?
Nov 15, 2001

Test show that Im drug resistant to everything also. Took Norvir for 5yrs, stopped due to bone wasting, change to Trizivir in May 2001 Viral load has bounced from 34,000 to 4,300 to 14,000. Would it due any good staying on this drug or is this going to be a hit and miss situation? I read somewhere that staying off cocktails for a while might help, also going back to old drugs may help. I'm Thinking about going back and trying Norvir again also do u think it may be a waste?

Response from Dr. Little

I cannot really advise you very well since you say you are resistant to everything, yet you only listed 4 drugs you have ever taken. The history of what you have taken and why you stopped (toxicity or virologic failure?) are critical in the decisions made about what to use next. There is a newer Protease inhibitor (Kaletra) which works moderately well in patients with resistance to most of the available protease inhibitors. You also did not mention the non-nucleoside reverse transcriptase inhibitors (NNRTIs) - several drugs in this class are very potent and could be paired with other (perhaps recycled drugs if you are truly limited in options) to give you a reasonable new treatment regimen. The decision to take a treatment holiday should be discussed with your provider. In general, I have not been terribly impressed with the benefits achieved following treatment interruption among patients with established HIV infection. There are also some risks associated with this approach. It may end up being a reasonable option, but not one I would recommend in general unless as part of a research study or under VERY CLOSE supervision. I would strongly urge you to ask your provider to review your resistance test results and your prior treatment history with you so that you can come up with a new regimen which you are willing to try and offers the best hope of achieving complete suppression. Good luck.


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