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Stocrin resistance ? Viral load detectable ?
Dec 29, 2010

I am coming again, if i did't take any kind of ARV(neither Stocrin ,neither Combivir, the ARV i was taking for long years , 8 years) for 2 months and i was for long years undetectable(8 years) and with a god CD4(>400) and after the break i start taking Kaletra and Combivir what will be the most probable evolution of me.What will be the chances to develop Stocrin resistance because i read somewhere that if you're good with virus on the meds(Efavirenez) then will not be no problem when you start to take Stocrin again. After the 2 months breake with stocrin and Combivir I've started to take Kaletra and Combivir. I am already taking Kaletra and Combivir for a month , what will be my chances like the virus to appear detectable and my CD4 not to drop to much .Is there any reason to get worry about the question that in the case that i didn't take nothing for two months and after that i've started on kaletra and Combivir and this terapeutic line will not work at all and another therapeutic line is needed? What will be my chances on Kaletra and Combivir and what will be the percentage like my virus to develop resistance to Stocrin.Is there any chance like the virus to didn't develop resistance to Stocrin like in the case of pregnant womens? If i develop resistance to Stocrin and to this terepeutic class what will remain for me ?

Response from Dr. Henry

Most patients who stop a Stocrine (efavirenz) based regimen when doing well will do OK if placed on an efavirenz regimen again but there is a risk for resistance development when efavirenz is stopped (I have seen it on our own clinic) if all meds stopped at once (often in our clinic would cover efavirenz "tail" with a boosted protease inhibitor for 1-2 weeks). Risk for efavirenz resistance may be higher when used with Combivir than with Truvada since the drugs in the latter combination last longer in the blood. Timed resistance testing can sort out the situation for some patients but such tests are not widely available in many regions of the world. Kaletra is usually active against efavirenz resistant virus. KH



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