Virtual phenotypes; what do they mean?

Question

I learned not long ago that I was infected with hiv and a virtual phenotype revealed I was resistant to NNRTI since there was a long red bar next to Efavirenz, Nevirapine and Rescriptor. There was also milder resistance to the nukes and practically none to the IPs, there was only a red dot next to most of them under the green line and some with no red dots (pardon the lack of scientifical vocabulary), does this mean that I have a "sleeping" resistance to the latter (IPs) that will be boosted when I have to take medication since there's only a red dot or is it really low resistance ? And is it possible to use drugs when we are partially resistant to them ?When the Virtual phenotype was done my CD4+cells were at 680 and viral load at 15000 and I believe I've been infected about a year ago and have never taken any medication. My cd4+ are now at 640 and VL 8000 after 6 months, I'm 26 years old.

Thanks in advance for your enlightment

Answer

A virtual phenotype is a prediction made as to which drugs are likely to work in your body based upon the combination of drug resistance mutations that are present in the virus that is measured by the test. It is very common for people who have a relatively common mutation to the NNRTIs to be resistant to all three NNRTIs on the basis of a single drug resistance mutation. Mild resistance to the nucleosides is probably the result of one or two mutations, but without knowing which ones, it is difficult to predict the virtual phenotype result. What this really means is that you will likely need three nucleosides or two protease inhibitors and 2-3 nucleosides to completely suppress your viral load. The choice of between these two categories should be discussed with your doctor - since I do not know which NRTI mutations you have and cannot therefore make a particular recommendation. Good luck.