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Scared of resistance
Apr 12, 2007

Dear Doctor D,

Hello. I was exposed to HIV early last year and have been on sustiva/truvada (soon to be atripla) for about 10 months. I have achieved an undetectable vl and I don't know my CD4 b/c my doctor didn't tell me last time I went in. She just said everything was fine. Regardless, I am very worried about resistance. I haven't missed any doses to date, even when I went backpacking in Central America, but I am still very nervous about going to the doctor's office one day to discover that resistant virus is emerging despite my diligence in taking the medication every day. Is there anything you can say to allay these fears. Thank you.

Response from Dr. Daar

Thank you for your posting.

This is a great question because I know that many share your concerns. Like everything else in life we tend to focus on what might go wrong and it sometimes prevents us from enjoying all that is going right. First and foremost I would like to reassure you that in your situation most data suggests that taking your medications consistently should keep your virus suppressed and prevent the development of resistance. That said, there are no guarantees in life.

Everyone deals with this kind of anxiety and uncertainty differently. I personally think the best way to cope is defining in ones mind what the consequences would be if the worst case scenario occurred. The good, actually great news for people like you is that even if you did develop resistance there are still many options currently available that are likely to allow you to regain complete viral control. Even better, the number of options are only growing with time.

Keep up the good work. Enjoy your success!!

Best, Eric


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