Dr.Boyle

When hiv specialist choose medications for hiv these days do they assume that the combo is eventually going to fail or do they initially belive that if the combo is adhered to it will work indefinately? If a person stays faithful to their medicines what are their chances of the regimen not working indefinately?

An interesting question. Clinicians actually do both,that is, they try to select a regimen that will work for a very long time and that at the same time preserves future treatment options should failure and resistance occur. If the patient achieves an undetectable viral load (<50) and stays religiously adherent to the regimen the failure rate for the more potent regimens (e.g., those that involve lopinavir/ritonavir [Kaletra] or efavirenz [Sustiva/Stocrin]) should be in the 1-3% range per year of therapy. Thus, while failure may eventually occur in all patients, it can be a very, very long time before that happens in most of the patients if they stick to the regimen.