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Jul 21, 2006

My husband has recently become resistant in the last 3 years. We are patiently waiting for the TMC114 to hit the pharmacy. Along with that he will try again the T20 and another drug to make 3 drugs. Right now he is on nothing;since Dec 05. His viral load is 250,000 very high and his T cell is 27. If this doesn't work do we give up? Do we just wait it out for him to die? I don't know why I did not get the virus, for we were married 3years before we found out he was positve. I have committed myself to stay back then and I will not give up now. But to see it, and live with someone going through is hard. I just don't know what else I can do. I have left my job due to his mental and physical health. Some day are good and others are not. He has lost so much weight. I have been in the social service field for over 20 years with the last 12 in substance abuse and HIV. I can tell you it is a difference when you are affected by this diease. Another question, should I try some tails, like at Yale HIV clinic? I have heard that they do such things there.Or, do I just let him live the rest of his life the best he can? Help!

Response from Dr. Daar

Hi Hopeful, Thank you for your post. I understand how difficult this time must be for you, your husband and the rest of your family. It sounds like the two of you have been working closely with his provider to make the best decisions possible. The decisions as to what therapy to start next is best made in concert with his provider who has access to his complete treatment history and any drug resistance testing that has been performed. From this information the best options can be defined and a trial of therapy initiated.

While I am generally optimistic, it is sometimes difficult when people are running out of options. However, we are on the brink of what may be an extremely exciting time in the management of HIV disease as several new classes of drugs are moving through clinical trials. While new PIs, such as TMC114 (darunavir) and tipranvir are exciting new options for some with resistant virus, not all people will respond. In contrast, drugs in new classess may be of value to many if not all people experienced with other drug classess. Examples of what is on the horizon are the integrase inhibitors, chemokine receptor inhibitors and maturation inhibitors. It is because of the new drugs becoming available in existing classes and those in new classes that I continue to hold out hope for people like your husband. When time is of the essence a great way to access new drugs before they become available is through clinical trials. For this reason I would encourage you to contact any and all research centers in your area to explore potential studies for the treatment-experienced patient.

Best to you and your husband. Eric

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