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Treatment Failure Within 2 Years?
Oct 30, 2009

Dr. Henry,

I've read a lot of info about most people experiencing treatment failure within 2 years. This was very disturbing to me. All my docs and other experts keep telling me I should live an almost normal life-span. If this is true, then I thought there must be tons of drug regimens if most experience treatment failure within 2 yrs on a particular regimen. How else could HIVers live a near normal life-span with high treatment failure rates??

I'm not on meds yet. I believe I was infected 8 yrs ago, but my CD-4 has remained very high and VL very low. I've read so much about better outcomes beginning meds earlier (above CD-4 500). I thought about going ahead and starting meds. It has been a tough decision. I get different answers--some say start and others say wait.

If treatment failure is a real problem, wouldn't beginning meds start the clock on the treatment failure? Also, I was talking to someone who works at the HIV practice I go to. He's not a doctor. He said most of those treatment failures were due to poor adherance. He said if I maintained good adherance, there's no reason I couldn't do well on the same regimen for years--even decades. Is he right or do the best med takers end up with failure?

Thanks for your time. I was just reading the study on this website about this very issue. It talked about people experiencing 2nd treatment failure having higher death rate. I guess this means there are currently only a few regimens and once those fail that's it? I know we are all different and the virus affects us all differently. It just seems like when I read a very optimistic study, it is often followed by a depressing one.

Thanks so much.

Response from Dr. Henry

Treatment failure is a risk if patients miss lots of doses and/or there are lots of interrptions in treatment (due to insurance issues, social setting, et cetera). Our large HIV clinic has experienced true virologic treatment (with drug resistance) failure in less 1-2% of patients over the last several years (generally due to interruptions or missed doses of efavirenz based regimens for a variety of reasons)so treatment failure with current drug regimens is not common and is becoming even less frequenty with many back up options in case such failure is encountered. KH



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