Treatment Ineffective in 15%?

[northernguy]

In one of the articles about the HAART - Chemo combo possibilities, I found the stat that HAART is ineffective in 15% of the HIV+ population!  That shocked me, has anyone else seen that figure?

[positivmat]

I thought that was way high too. Would like to hear more about that

[Miss Philicia]

I wouldn't be surprised if that figure is that high exactly because of those long-term survivors that developed resistance issues from pre-HAART regimens, so even now days they often develop resistance issues.  Combined with post-HAART patients with adherence issues (untreated mental health issues and substance abuse often drive those numbers) and it's easy to see this.

Of course, maybe some of you just want something new to worry incessantly about.

[positivmat]

Well worrying is a great hobby if you can perfect it. I wasn't too worried the hour long session it took me to get this bug. No my atripla is working fine. The LTS explains it. I assumed they meant first line treatment.
Matt

[Assurbanipal]

Believe that is a per regimen number.  It's consistent with the following observation in the US treatment guidelines that broadly summarizes clinical trial results:

"Successful outcomes are not always observed. Viral suppression rates in clinical practice may be lower than the 80%–90% seen in clinical trials, although the use of current compact, potent, and well-tolerated regimens has probably decreased this difference in outcomes between clinical trials and clinical practice"
http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf  p.18

But just generally, depending on the study, 10% to 20% of the late diagnosed (have AIDS at diagnosis) die within a year of diagnosis.  About 30% to 40% are late diagnosed.  That would account for about half of the 15% number.

Some of the remainder are accounted for by the statement in the US treatment guidelines per regimen.

And finally, treatment experienced with multidrug resistant virus.

Medicine doesn't have guarantees; there is room for gratitude and wonder that we remain alive...

[hotpuppy]

I think you need to look at the population.  In general, guys who do drugs, party, drink like fish, and live hard tend to also skip doses, and thus fail treatment.  Is that the treatment's fault?  I don't think so.

We all have choices to make that influence how long we live.  Do you take your meds? Show respect to large moving vehicles when crossing the street? both decisions impact the extent of your life.  If you don't put your meds first you aren't putting your life first.  It's that simple.  It's that serious.

[Miss Philicia]

I see plenty of straight women at my clinic that are drug users.  This isn't just a gay man's disease.

[dixieman]

I see plenty of straight women at UAB in Birming, AL where their boyfriends and husbands have brought home this virus likewise.