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Expected time until treatment failure, near perfect adherence

Oct 31, 2003


I have been unable to find any research or data regarding expected time to failure on certain drug regimens, given near perfect adherence to therapy by the patient.

I do understand that there are many complex factors that go into developing certain viral mutations resulting in failure of a particular therapy, but would appreciate any information you could provide specific to my situation.

Diagnosed positive in Feb. '01, VL at 50,000 and CD4 count at 70. Started a Combivir/Sustiva regimen in Mar. '01. Since that time, VL has fallen to undectectable, CD4 is up to 420.

I have near perfect compliance, missing a dose only once every 3 months (or more). I am a healthy 27 year old male, on a good diet and exercise regularly.

Do you have any thoughts on how long until this Combivir/Sustiva regiment fails? Or is it simply impossible to tell? Is it more likely to be next month, next year, or next decade? Assuming no significant advances in HIV treatment (hopefully an unrealistic assumption), what would my life expectancy be? Any thoughts you have would be appreciated. Thanks.

Response from Dr. Conway

Congratulations on such an excellent response to therapy. To date, there are data on people remaining with undetectable viral loads on Sustiva-Combivir for as long as 6 years (as long as the combination has been available). Beyond that, we really cannot tell, but there is every reason to believe that, as long as you take your pills, you will maintain your health indefinitely. What's more, as far as lipid changes and lipodystrophy go, you are on a regimen that has been associated with a very low risk of such complications.

Keep up the good work, and DO make long-term plans!!!!

Triglycerides at 580 Follow-up
Kaletra and caffeine

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