I started treatment in November 2006 witn Nevirapine, Stavudine and Lamivudine (old drugs you may say but that is what is available in Nigeria)and I have been fine since. Now I'm begining to notice again mouth ulcer in my mouth and this was one of the initial pointer for me in the beginning. I've been committed to my drugs without missing except one one occasion when doctors went on strike and I ran out of drug for some 5 days.Question is, does it mean that the drugs are becoming resistant? If this is yes, then there is problem as there seems to be no alternative around here. Thanks.

Thank you for your post.

I understand that different drugs are available in select parts of the world. While stavudine, lamivudine and nevirapine are used with decreasing frequency in the US and Europe they certainly are very effective agents. The presence of oral ulcers alone is not a sign of drug resistance. Unfortunately, without viral load testing it is very difficult to know when resistance may be emerging in someone on any regimen. If such tests are not available to you then you will need to rely on CD4 cell counts. Hopefully your treatment is still working and when the time comes that you need new options they will be available to you. I know that increasingly protease inhibitors are becoming avaialble for nevirapine failures.

Best, Eric