Resistance

[tommy246]

When i had my diagnosis 3 december 08 i am sure i heard my doctor say that i was going to be tested for resistance however on my last visit in april i asked him about it and he said they dont test for resistance until you need meds ,i live in spain is this correct as i have read different elsewhere.

[elf]

I don't think resistance test is needed for naïve patients. I've never had a resistance test taken.
I was going to be given efavirenz, but due to my history of depression, they gave me Kaletra instead, so far so good.

[mecch]

Besides the opinion of your Spanish doctor, and the wise people here,

you can ask questions of HIV experts (DOCTORS) at Johns Hopkins University
http://www.hopkins-hivguide.org/soap/AskAQuestion?navigationId=254312&publicationId=7147&siteId=7151&forum=Patient

and also at thebody.com

I had resistance testing during serocoversion. I don't know why - you'd have to ask the experts. Do that.
 

[mecch]

I don't think resistance test is needed for naïve patients. I've never had a resistance test taken.
I was going to be given efavirenz, but due to my history of depression, they gave me Kaletra instead, so far so good.

Elf, not to worry you, but in many countries, it is considered standard best practice protocal to do resistance testing before starting HAART.  That's how doctors chose the most effective drugs.  I don't know why you didn't have one, maybe its the procedure where you live. You could ask your doctor about that. 

[BlueMoon]

In order for resistance testing to mean anything, there has to be something to be resistant to, i.e HAART.  Even if you tested now, you would still need to test when it's time to begin meds, because your resistance profile could change between now and then.

Be patient, your time will come. 

[newt]

A resistance test before treatment is useful. There are schools of though eg the one closest to diagnosis is most accurate, the one immediately before treatment is most accurate. What is important it that you have one before you start treatment. 

Resistance tests are not perfect intelligence, but they are recommended in guidelines, mainly because the rate of transmitted infection is a few % and it is important to know if drugs won;t work, which is what a resistance test tells you.

- matt

[tommy246]

Thanks guys just me being paranoid.

[LordBerners]

Maybe I didn't understand my doctor, but he told me that 'for the resistance test to give any useful results it would have to be taken while on meds'.   He actually kept me on meds for several weeks till I could get a resistance test, even though it was already clear that my viral load was through the roof (after having been lowered by the meds for some months) and thus I must be resistant.  He said that he kept me on the meds purely to get a more useful resistance test result.  Does that make any sense?

[joemutt]

Correct me if I' m wrong but isnt resistance testing particulary
effecive beforetreatment to see which meds your virus may already
be resistant to, so as to avoid these meds in the first protocol of treament? 

[LordBerners]

Correct me if I' m wrong but isnt resistance testing particulary
effecive beforetreatment to see which meds your virus may already
be resistant to, so as to avoid these meds in the first protocol of treament? 

Yeah that is what I would have guessed.  I'm not sure what my doctors are up to here, but they did not suggest any resistance testing before beginning ARV (I even asked if it would be adviseable), and then they did as reported in my above post. 

I was very confused by what was going on, and did ask for some explanation.. the doctor told me that 'in the case of testing for resistance when not on meds, it can be heard to detect the resistant virus, as the 'wild' or non-resistance virus is more healthy or efficient at propagating itself, so that it will predominate in the body - in other words the resistant examples will be such a tiny percentage of the untreated viral load that they may not show up'.

I would like to apologize to all if what is in my post is in any way misinformation, and I would encourage no one to lend it any credence for any purpose.  I'm just reporting what they told me and sharing my befuddlement.

[mecch]

Never heard of what your doctors have done, Berners. 
However common sense would indicate that you are resistant to the combo let failed, and therefore the protocal I believe is to change you ASAP to an effective combo.  You need  certain viral load to test, so perhaps they were testing to see what will (would) be the next effective combo to try. 

So, did you switch, and how is it going?

[Assurbanipal]

There's a good lesson on here about resistance testing http://www.aidsmeds.com/articles/Resistance_4742.shtml

It is recommended both in advance of starting treatment and (again) while on a failing regimen.

[LordBerners]

Berners... did you switch, and how is it going?

I did, thanks for asking, mecch, to reyetaz, norvir, atanazavir, and with tenofovir being the only holdover from the old regime (sustiva/truvada).  So far I've been on this combo for almost four months, with no short term side effects at all.  Of course it is too soon to tell what the theraputic results are.  I go back to the doctors in a couple of weeks, so we'll see.

[blondbeauty]

Hi Tommy. I also live in SPAIN. I was tested for resistance but at the clinic where I was diagnosed. At my hospital I was never tested. My Dr. said it was not useful if the infection was old and he would only test me if the treatment did not work. I was as paranaoid as you where. Finally my first treatment worked perfectly.
Juan

[Miss Philicia]

You can have a resistance test done if you are on HAART but ONLY when your VL is not suppressed.