Hi Dr. Daar,

I wanted to give a quick follow up to my last message (titled My latest updated - you posted your answer on 5/29). I want to point out that I was treatment naive prior to 12/14/05, so I was NOT on any meds when the Sept and Nov 2005 labs were drawn. Sustiva/Truvada is my only regimen to date. I had a resistance test drawn prior to leaving for Europe, so the results should be ready when I return next Monday. My last discussion with my doctor leads me to believe that I may have been infected with a resistance virus -- so we are thinking about changing me to a PI when I return. Having less than maximum effectiveness for the NRTI backbone seems to me to be too risky with Sustiva (or any NNRTI). So, even though I had hoped to "save" PIs for later, I guess later got here sooner than I planned. Now, of course, which PI? I'm spending little time thinking about it right now -- I just sailed from Venice and have 3 more days of my cruise vacation -- I'll worry about it after -- so, Yes, I am definately enjoying my vacation. Thanks again for any additional insights now that i have answered your question about my previous treatments. Mike

Thank you for the update.

It certainly appears that you did acquire a drug resistant virus. Although the strain may be susceptible to your current regimen, it does raise concerns, particularly if your viral load does not go to undectable levels. If indeed this is the case a PI is the appropriate next step. The good news is that there are many well tolerated agents that should be very effective. Each has different issues of dosing and side effect so you do need to go through all of this with your provider upon your return.

Safe travels. Best, Eric