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Author Topic: Confused about resistance issues, please explain!  (Read 1024 times)

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Offline TabooPrincess

  • Member
  • Posts: 279
Confused about resistance issues, please explain!
« on: April 01, 2012, 03:31:57 PM »
I'm in the process of discussing what treatment to start on at the moment with the hope and intention that this is within the next few weeks (given my numbers are not so great anymore).

The problem being that my doc has 'hinted' towards me being resistant to truvada because the man who infected me is resistant to it (although this is all very cloak and dagger as I'm sure they're being careful about confidentiality).  Now, the ex has never been on truvada AND I was tested for resistance in pregnancy and have nothing.  I'm confused - does this make sense to anyone at all?  It's driving me mad thinking was he on meds in the past and so knew his status all along (but wouldn't that mean he passed that resistance to me during pregnancy), or has he slept with someone since and become resistant.  Blah blah blah

As far as I'm aware he's only been on one treatment regime (kivexa, kaletra and viread) and despite being quite terrible with it has not become resistant.

Please someone explain all this - I'm worried that my medication options are now limited but I don't fully understand how or why  :(
09/ 2008 - Seroconversion
11/2008 - Tested pos, cd4 640 vl 25400
12/2008 - cd4 794 vl 27798, 35%
03/2009 - cd4 844 vl 68846, 35%
06/2009 - cd4 476 vl 49151, 33% (pregnancy confirmed)
08/2009 - cd4 464 vl 54662, 32%
Started meds for pregnancy (Kaletra, AZT, Viread)
09/2009 - cd4 841 vl 3213, 42%
10/2009 - cd4 860 vl 1088, 41%
11/2009 - cd4 771 vl 563, 38%
12/2009 - cd4 885 vl 151 42%
Discontinued meds after baby born
02/2010 - cd4 841 vl 63781, 38%
05/2010 - cd4 1080 vl 113000, 39%
08/2010 - cd4 770 vl 109242
12/2010 - cd4 642 vl 111000, 34%
06/2011 - cd4 450 vl 222000, 33%
11/2011 - cd4 419 vl 212000, 24%
03/2012 - cd4 280 vl 118000, 26% (repeated Cd4 at 360)
05/2012 -cd4 360 vl 99,190
10/2012 Atripla, cd4 690, vl 80
12/2012 Darunavir, norvir, truvada, Cd4 680, vl u/d
07/2013 cd4 750,ud

Offline leatherman

  • Member
  • Posts: 6,060
  • Google and HIV meds are Your Friends
Re: Confused about resistance issues, please explain!
« Reply #1 on: April 01, 2012, 04:57:01 PM »
can't you just get a genotype test done on yourself, instead of everyone guessing? Your doctor might as well guess that you have NO resistance. without any legitimate proof (and going by what someone else took, or what someone else "might" be resistance to is no proof whatsoever) your doctor is just blowing smoke at you.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline buginme2

  • Member
  • Posts: 2,834
Re: Confused about resistance issues, please explain!
« Reply #2 on: April 01, 2012, 06:34:29 PM »
If your doctor is determining your resistance profile based on a hunch and not from the results of a genotype test, I'd find a new doctor.

Offline TabooPrincess

  • Member
  • Posts: 279
Re: Confused about resistance issues, please explain!
« Reply #3 on: April 02, 2012, 11:01:28 AM »
I am waiting on the results from the resistance test but she told me that it doesn't always show up properly with the resistant strains.  I really don't understand it all.  I just thought it was resistant or not?!  And the rest is more just confusion as to why things 'may' be different now when I've not had unprotected sex since i was preggers.
09/ 2008 - Seroconversion
11/2008 - Tested pos, cd4 640 vl 25400
12/2008 - cd4 794 vl 27798, 35%
03/2009 - cd4 844 vl 68846, 35%
06/2009 - cd4 476 vl 49151, 33% (pregnancy confirmed)
08/2009 - cd4 464 vl 54662, 32%
Started meds for pregnancy (Kaletra, AZT, Viread)
09/2009 - cd4 841 vl 3213, 42%
10/2009 - cd4 860 vl 1088, 41%
11/2009 - cd4 771 vl 563, 38%
12/2009 - cd4 885 vl 151 42%
Discontinued meds after baby born
02/2010 - cd4 841 vl 63781, 38%
05/2010 - cd4 1080 vl 113000, 39%
08/2010 - cd4 770 vl 109242
12/2010 - cd4 642 vl 111000, 34%
06/2011 - cd4 450 vl 222000, 33%
11/2011 - cd4 419 vl 212000, 24%
03/2012 - cd4 280 vl 118000, 26% (repeated Cd4 at 360)
05/2012 -cd4 360 vl 99,190
10/2012 Atripla, cd4 690, vl 80
12/2012 Darunavir, norvir, truvada, Cd4 680, vl u/d
07/2013 cd4 750,ud

Offline newt

  • Member
  • Posts: 3,877
  • the one and original newt
Re: Confused about resistance issues, please explain!
« Reply #4 on: April 02, 2012, 05:17:22 PM »
Bumby bumby rubbish doc, docs should be clear not hint.

1. Resistance is either transmitted (ie you got a resistant strain in the first place) or acquired by not taking drugs properly (ie the virus get the chance to change because the meds are not suppressing it).

2. HIV is always a mix, and sometimes resistant strains are hidden, and only come out on taking treatment. These do not always show up on resistant tests. The only way to detect these is when you take meds and your viral load don't go below 50.

3. If the man who gave you HIV is effectively treated on his combo then regardless of what the tests say you are likely to respond well to treatment using similar drugs to him (or maybe one less, Kivexa + Viread is kinda 1 drug too many maybe).

4. Truvada resistance is not straightforward. The most common mutation which in theory show one of the drugs in Truvada to be ineffective can sometimes make this pair of drugs more effective.

5. That your viral load dropped so well when you were pregnant on a combo containing Viread suggests, practically, Viread will work for you. However, you only took Viread for a few months, so maybe not quite long enough to tell.

6. Do you have your resistance test results? This would allow a more informed comment.

Hope this helps.

"The object is to be a well patient, not a good patient"

Offline TabooPrincess

  • Member
  • Posts: 279
Re: Confused about resistance issues, please explain!
« Reply #5 on: April 03, 2012, 04:02:49 AM »
Thanks Newt - that did help.  I am really keen on starting on one of the one pill a day regimes but I'm now concerned that they may not allow me to do this now.  You say that resistance sometimes doesn't show until you are actually on the combo - so would it be sensible/wise to start on a one pill a day regime and hope for the best?  Or if there is a question that I am resistant to truvada (even tho it may not show as it's 'hidden') then wil I have to have something completely different?

Hope this makes some kind of sense....?!

Still waiting on the resistance results which apparantly takes around 6 weeks to come back - but if it may be 'hidden' anyway then what's the point?!! lol
09/ 2008 - Seroconversion
11/2008 - Tested pos, cd4 640 vl 25400
12/2008 - cd4 794 vl 27798, 35%
03/2009 - cd4 844 vl 68846, 35%
06/2009 - cd4 476 vl 49151, 33% (pregnancy confirmed)
08/2009 - cd4 464 vl 54662, 32%
Started meds for pregnancy (Kaletra, AZT, Viread)
09/2009 - cd4 841 vl 3213, 42%
10/2009 - cd4 860 vl 1088, 41%
11/2009 - cd4 771 vl 563, 38%
12/2009 - cd4 885 vl 151 42%
Discontinued meds after baby born
02/2010 - cd4 841 vl 63781, 38%
05/2010 - cd4 1080 vl 113000, 39%
08/2010 - cd4 770 vl 109242
12/2010 - cd4 642 vl 111000, 34%
06/2011 - cd4 450 vl 222000, 33%
11/2011 - cd4 419 vl 212000, 24%
03/2012 - cd4 280 vl 118000, 26% (repeated Cd4 at 360)
05/2012 -cd4 360 vl 99,190
10/2012 Atripla, cd4 690, vl 80
12/2012 Darunavir, norvir, truvada, Cd4 680, vl u/d
07/2013 cd4 750,ud

 


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