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ARV Resistance
Sep 18, 2013

I have a questin. This got me worried. I have been on ARV since November 2012. My meds are Efav and Lami/Zido. My first CD4 was 169 and my second, which was on May 2013, was 325. My partner tested negative on May 2013 but he tested positive just this September 2013 and his CD4 is now 298. He will most likely start taking ARV soon. What I want to know is what the likelihood is of him not responding to Efav and Lami/Zido combination since that's the combination that I am taking, which means that when the viruses have moved to his body, they must have already developed resistance to those ARV combination? I'm not sure, but will he have to be taking the second line drugs instead of the first line? I'm not very knowledgeable but the first line drugs are just the Nevirapine and Efavirenz right? I'm thinking in advance, in case he's not good with Nevirapine because that's highly allergy-causing, will he also most likely not be good with Efavirenz-based meds? I just wished that he will still be good with first lline drugs for obvious reasons, so that's why I'm wondering what the likelihood is.

Response from Dr. Henry

Lot's of good questions there. If your HIV level has been tested (such testing often not available in many places) and is < 50 copies/ml (sometimes termed below the detection limit) then odds that you infected your partner are low but still possible. Situation depends on many other partners he has had and the timing of other sexual relationships and the type of activity engaged in. If it seems likely that he may have become infected from you and HIV levels are not available to sort out (as well as resistance testing) then consideration of use of a 2nd line regimen (usually involving a boosted protease inhibitor such as ritonavir + lopinavir or atazanavir)merits discussion with his HIV doctor. KH



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