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Responsive Database Initative
Aug 31, 2003

I have spent a good part of my life studying numbers used in the predictive analysis of world markets, financial outcomes, etc...I have read something with great interest about an organization callling themselves RDI, HIV Resistence Response Database Initiative. In my short experience in being diagnosed and treated for HIV infection, the methods they are trying to apply in predicting HIV virological failure to responses in HIV MEds prior to the administration of these meds seems a very worthwhile project with promising results. I have a few questions..Outside of the costs associated with exploring the genetic typing of HIV in each individual, why couldn't an initial treatment protocol begin with going right after the "monster" knowing what it is and which treatments have represented the most effective path to reaching desired clinical state from the onset? It appears from what I have been reading, there are a few standard treatment protocols implimented in the first stages of HIV treatment that are more of a shotgun type approach. It seems to me that some people could benefit from the humilation of initial failures, and physiological stress of a greater than needed med protocol. Less is more? Just interested in knowing ...

A friend from the Pocono Mountains......

Response from Dr. Henry

An interesting concept-thanks for the message. I usually make check the resistance profile before starting HIV meds (which are chosen by the patient after a discussion of a wide range of options). I generally recommend starting treatment aggressively with little chance for development of resistance (drugs with a high barrier to resistance such as Kaletra) and then switch to an easier regimen once the viral levels are undetectable. There are a wide range of simple regimens available that can be individualized based on patient choice/characteristics. KH



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