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Author Topic: Resistance  (Read 2024 times)

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Offline tommy246

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Resistance
« on: May 03, 2009, 03:40:33 PM »
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.
jan 06 neg
dec 08 pos cd4 505 ,16%, 1,500vl
april 09 cd4 635 ,16%,60,000
july 09 ,cd4 545,17%,80,000
aug 09,hosptal 18days pneumonia cd190,225,000,15%
1 week later cd4 415 20%
nov 09 cd4 591 ,vl 59,000,14%,started atripla
dec 09  cd4 787, vl 266, 16%
march 2010  cd4 720 vl non detectable -20  20%
june 2010  cd4  680, 21%, ND

Offline elf

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Re: Resistance
« Reply #1 on: May 03, 2009, 03:56:06 PM »
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.
Let's have a Kiki!

Online mecch

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  • red pill? or blue pill?
Re: Resistance
« Reply #2 on: May 03, 2009, 05:04:03 PM »
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.
 
“From each, according to his ability; to each, according to his need” 1875 K Marx

Online mecch

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  • red pill? or blue pill?
Re: Resistance
« Reply #3 on: May 03, 2009, 05:07:52 PM »
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. 
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline BlueMoon

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  • Calling from the Fun House
Re: Resistance
« Reply #4 on: May 03, 2009, 10:21:17 PM »
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. 
...................VL.....CD4.....%
-----------------------------------------
08/10-- ......<40.....290.....42
05/10-- ......<48.....290.....46
02/10-- ......<48.....481.....44
10/09-- ......<48.....277.....46
07/09-- ......<48.....300.....38
05/09-- ........51.....449.....39
03/09-- Added Isentress
02/09-- ........65.....299.....34
11/08-- ........62.....242.....40
08/08-- ........66.....212.....29
05/08-- ......202.....217.....27
03/08-- ....5210.....187.....21
02/08-- Began Truvada/Reyataz/Norvir
12/07-- 273,000.....157.....22
11/07-- 229,000.....209.....22
10/07-- Diagnosis

It's a complex world.

Offline newt

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  • the one and original newt
Re: Resistance
« Reply #5 on: May 04, 2009, 09:25:46 AM »
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
"The object is to be a well patient, not a good patient"

Offline tommy246

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Re: Resistance
« Reply #6 on: May 04, 2009, 09:31:51 AM »
Thanks guys just me being paranoid.
jan 06 neg
dec 08 pos cd4 505 ,16%, 1,500vl
april 09 cd4 635 ,16%,60,000
july 09 ,cd4 545,17%,80,000
aug 09,hosptal 18days pneumonia cd190,225,000,15%
1 week later cd4 415 20%
nov 09 cd4 591 ,vl 59,000,14%,started atripla
dec 09  cd4 787, vl 266, 16%
march 2010  cd4 720 vl non detectable -20  20%
june 2010  cd4  680, 21%, ND

Offline LordBerners

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  • Posts: 415
Re: Resistance
« Reply #7 on: May 06, 2009, 12:10:32 PM »
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?
Please, just call me Berners.. or Baron.

Offline joemutt

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Re: Resistance
« Reply #8 on: May 06, 2009, 12:26:51 PM »
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?  ???

Offline LordBerners

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Re: Resistance
« Reply #9 on: May 06, 2009, 12:55:51 PM »
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.
Please, just call me Berners.. or Baron.

Online mecch

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Re: Resistance
« Reply #10 on: May 06, 2009, 02:30:35 PM »
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?

“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Assurbanipal

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  • Taking a forums break, still see PM's
Re: Resistance
« Reply #11 on: May 06, 2009, 03:33:44 PM »
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.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline LordBerners

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  • Posts: 415
Re: Resistance
« Reply #12 on: May 08, 2009, 06:53:13 PM »
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.

« Last Edit: May 08, 2009, 07:01:41 PM by LordBerners »
Please, just call me Berners.. or Baron.

Offline blondbeauty

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  • Posts: 1,784
Re: Resistance
« Reply #13 on: May 08, 2009, 08:10:24 PM »
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
The only member in these forums approved by WINBA: World International Nail and Beauty Association.
Epstein Barr +; CMV +; Toxoplasmosis +; HIV-1 +.
Counts when starting treatment:
V.L.:80.200 copies. CD4: 25%=503
Started Sustiva-Truvada 14/August/2006
Last V.L.count (Oct 2013): Undetectable
Last CD4 count (OCT 2013): 52%= 933

Offline Miss Philicia

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  • celebrity poster, faker & poser
Re: Resistance
« Reply #14 on: May 08, 2009, 09:59:21 PM »
You can have a resistance test done if you are on HAART but ONLY when your VL is not suppressed.
"I’ve slept with enough men to know that I’m not gay"

 


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