The Body's "Ask the Experts" Forums
FAQs About Treatment for HIV Treatment Veterans From The Body's "Ask the Experts" Forums
Drug Resistance
- I have almost complete resistance to NRTIs (nucleoside reverse transcriptase inhibitors) and first-line NNRTIs (non-nucleoside reverse transcriptase inhibitors), and partial resistance to protease inhibitors. What are my options?
- I began HIV meds about 17 years ago. My resistance tests show that I am resistant to all protease inhibitors except Prezista (darunavir) and all NRTIs except Viread (tenofovir). My doctor put me on Norvir (ritonavir), Prezista, Isentress (raltegravir) and Atripla (efavirenz/tenofovir/FTC). Am I getting near the end of the road in terms of my options?
- I am one of those "forgotten patients" whose HIV is resistant to many meds -- even Isentress (raltegravir). I feel like the few of us left with multidrug-resistant HIV are going to be forgotten and die without help. What are the U.S. Food and Drug Administration and AIDS researchers doing for us, the forgotten few?
- I was recently diagnosed with HIV and had resistance testing done. The results show that, out of 19 different HIV meds, I'm already resistant to two of them: Sustiva (Stocrin, efavirenz) and Viramune (nevirapine). How can this be possible if I've never taken any HIV meds, let alone those two?
- I was infected with a strain of HIV that's resistant to the three major classes of HIV meds. My doctor has proposed a bunch of new medications and short-term use of Fuzeon (enfuvirtide, T-20) -- for only six months. Would stopping Fuzeon after six months make me develop resistance to it?
- I recently started taking Combivir (AZT/3TC) and Sustiva (efavirenz, Stocrin). However, I just learned that I have the M184V mutation, which indicates resistance to 3TC (lamivudine), a component of Combivir. I can't switch meds for another week because I'm working abroad and don't have access to HIV meds here. Will my 3TC (lamivudine) resistance make me resistant to Sustiva also, before I am able to change my regimen?
- After 12 years of HIV treatment, I have become resistant to some protease inhibitors, all NNRTIs and nearly all NRTIs. For the last year I've been taking Epzicom (abacavir/3TC, Kivexa) alone. I know that's not a good long-term strategy, but I seem to have few options. How can I find a drug combo that's effective and resistance-proof?
- I'm highly drug resistant, and my doctor just started me on a new, unproven drug regimen. If I become resistant to one or more of these new drugs too, what's next for me?
- I've heard that even if you are resistant to an HIV drug, that drug might still have some effectiveness. Is that true? Is drug resistance a matter of degree?
- I'm resistant to almost all HIV meds. However with two newly approved drugs, I was able to get my viral load below 200. Is that good enough or should I be striving to become undetectable?
- My HIV drug resistance test found no resistance to NRTIs or NNRTIs, but it did list a handful of "other mutations." What do these mutations mean?
- Does my decreasing CD4 count mean that I'm becoming resistant to my meds, even though my viral load is still undetectable?
- I stopped taking HIV meds almost two years ago, but now I need to restart treatment. An old resistance test showed resistance to a good number of meds. What are my options now?
- I'm highly resistant to all currently available HIV meds. Would any meds from my old regimens be effective if I started taking them again?
- If a phenotypic resistance test says that I have "complete" resistance to an HIV medication, what does that mean?
- If I stay 100 percent adherent to my HIV meds, can I avoid resistance, or will it inevitably develop at some point?
Switching Treatment
- What are good HIV meds to change to in order to decrease my risk of another heart attack?
- Two months ago, my doctor had me switch to a new regimen containing six HIV meds, including two drugs I have resistance to. Before I started this new drug combo, my viral load was undetectable, and it still is now. My CD4 count has also gone up a bit. Why does my doctor have me take meds I'm resistant to?
- I am resistant to NRTIs (nucleoside reverse transcriptase inhibitors) and I've never taken a protease inhibitor or NNRTI (non-nucleoside reverse transcriptase inhibitor). My doctor wants me to try a new regimen consisting of Atripla (efavirenz/tenofovir/FTC), Selzentry (maraviroc, Celsentri) and Isentress (raltegravir). Is this a good combo for me?
- I'm planning to get rid of the protease inhibitors in my current regimen, and will replace them with the NNRTI Intelence (etravirine). However, I have drug resistance to the older NNRTIs. Does this switch still sound like a good plan?
- I've been taking Sustiva (efavirenz, Stocrin) for the past four years, even though I have resistance to it, because there weren't any other options for me. Could I replace the Sustiva in my regimen with Intelence? What other options do I have?
- I've tried several different HIV regimens for about 20 years. My viral load consistently hovers around 1,000. I'm worried I may have developed resistance to a lot of HIV meds. How do I decide which HIV meds to try next?
- My viral load seems to be increasing. I have resistance to some HIV meds and am about to switch to a new regimen. Is it realistic for me to reach an undetectable viral load again?
- I'm already resistant to a few HIV meds, and now my doc wants to switch me off of Fuzeon (enfuvirtide, T-20), which is keeping my viral load undetectable, to "save" it for later. Is this a good idea?
- My doctor has told me to discontinue using a fourth HIV drug because my CD4 count has risen to a healthy level and my viral load is now undetectable. Will I still be able to use this drug in the future?
- I'm currently taking four HIV drugs, and I want to switch to the three-drug combo pill Atripla. My doc doesn't think it's a good idea because my resistance tests keep coming back inconclusive. What do you think? Can I safely switch meds?
- I haven't missed a single dose since I started meds three months ago, but I'm being told I have "fossils" of resistance to some meds. What does this mean? Do I need to switch meds?
Stopping Treatment
Resistance and Pregnancy
HIV/HAART Complications
For frequently asked questions on other HIV/AIDS topics, click here.
This article was provided by The Body's "Ask the Experts" Forums.
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