Hi, I live in West Virginia and Fuzeon is not included in the ADAP drug formulary. I met a spenddown for Medicaid and was able to get it for 6 months but am still waiting for final approval on my next spenddown. My Fuzeon runs out after today. I am multi-drug resistant and my CD4 count is aprroximately 150 but my last viral load test was <100,000. I may have to be without Fuzeon for a week or longer and am very worried about resistant issues. Also, do you know of any emergency programs for someone in my predicament. Fuzeon's PAP was no help to me before. Help! Mark

I will assume that the Fuzeon has been of help to you, both with respect to your CD4 count and your viral load but that your viral load has not been undetectable. Given these conditions, if you have been on Fuzeon for 6 months, it is likely that your virus is about to become resistant to it and that it will no longer be of benefit to you. I would begin by doing a resistance test on your virus to see if this has already happened. If so, you should consider stopping the Fuzeon anyway. If this is not yet the case, the resistance test could help you identify the agents that could be best combined with Fuzeon to produce the maximum benefit for you. The availability of such agents and the demonstration that Fuzeon will be needed to construct a truly suppressive regimen may well increase your chances of identifying an avenue to get you the Fuzeon reimbursed.

Good Luck...