Re: Just started my treatment today. - TheBody.com's Bulletin Boards

I wanted to add my two cents and disagree with iam1 on one point, though I agree with most of what he says. I do not think it is at all inevitable that your virus will become resistant to your meds if you are adherent and take them as scheduled. Based on my own experience (infected for more than 30 years and on meds since 1990) and the experiences of others I know, I have not seen a single case of viral resistance (in people on triple combination therapy) that was not linked to poor adherence to the regimen.

In my own case, I have been on a bunch of different HIV meds over the past 23 years, but I am only resistant to AZT (Retrovir), which was the first anti-HIV antiretroviral, and I took it in mono therapy (alone, there were no other drugs) for years and then in combination with 3TC after that. Mono therapy will definitely lead to resistance.

But in every other case, I have changed meds because of side-effects, not resistance, and in almost every case it has been because of side-effects that were more annoying than life-threatening. All of those discarded meds are still available to me if I needed to go back on one of them.

My point is that you shouldn't view resistance as an inevitable outcome. Strive for complete adherence and, if your current regimen doesn't cause you any difficulty, you could be on it indefinitely. Most likely, you'll switch at some point because another option has more convenient dosing or something, but who knows? It's important to remember that there will always be a finite number of drugs out there, and if you burn through them because of poor adherence, you are probably taking one or more meds — and sometimes entire CLASSES of meds — out of the mix forever, and really limiting your options. So don't take the attitude that you are going to become resistant, take the attitude that you won't let that happen.

There may be people that develop resistance despite perfet adherence, but from what I have seen, and from what my doctors have told me, that is rare or unlikely.

Finally, while you should, of course, be aware that side-effects may occur, you shouldn't see them as a foregone conclusion either. Most of the more modern HIV meds have very minor side-effects that are fairly rare. I haven't experienced any in a long time (my last med change was to get rid of a pill that was difficult to swallow!). Minor stuff.

Good luck to you—you sound like you have a great attitude and are getting good care, and if both of those continue you will live to be old and crotchety, just as I hope to. ;-)

Dave

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