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Author Topic: Resistance test  (Read 1556 times)

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Offline Valmont

  • Member
  • Posts: 332
Resistance test
« on: December 28, 2011, 10:44:17 AM »
Hi,  I wanted some opinion about the resistance test that is done to detect possible resistance the virus have against some meds molecules.

In Ecuador, this test is never done by public safety hospital and not considered, however when I asked, my doc recommanded me it would be good to do it.  Only one private clinic does it and it is more than US 800-1.000 (here it is a lot of money, for years I only earned 500 a month, but anyway, health is the priority and I can get this money, but I want it to be well invested...).  More over, this clinic administrate my private segure and Iīm not sure they will respect confidential matters...

My questions:

1- I read that these tests are not so trustable.  Is that true?  Do they really give a good indication about treatments?  Here, treatments access is quite poor (but not bad), they are not so many possible meds combination possible.  Putting this amount in that kind of test is a good idea, or should I keep it for the future, better food or travelling somewhere to buy medecine that is not in Ecuador?  Should I do it?  Have you done it?  What are the benefices?

2- What do you think of the price? 

3- I will travel to UE in a few months, Portugal maybe, Spain and France and can eventually go to Switzerland or Germany.  Do you know if that kind of test can be easily done there?  How much can they cost?  The better place?....  I donīt have insurance in Europe.

Iīm not on med, no idea of my Cd4 and VL from June, I was in lab last Monday for that and will have the result in 4 to 6 weeks more.


Your comments will be very very well received...
Apr 2011: Diagnotized
Jun 2011: CD4: 504  VL: 176.000
Dic 2011: CD4: 714  VL: 95.000
May 2012: CD4: 395 VL: 67.000
Jun 2012: CD4: 367
Agu 2012: Starting Emtricitabine 200 mg / Tenofovir 300 mg and Efavirenz 600 mg (2 pills) different brands or VIRADAY/ATRIPLA/Mylan....
Sep 2012: VL: 138
Dic 2012: CD4: 708 VL: <34  %CD4: 32%
Jan 2013: CD4: 707 VL: <20
May 2013: CD4: 945 VL: <34 %CD4: 33%
Agu 2013: CD4: 636 VL: <34 %CD4: 50%
Dic 2013: Latent TB, started Isoniazid

Offline geobee

  • Member
  • Posts: 281
Re: Resistance test
« Reply #1 on: December 28, 2011, 12:29:16 PM »
I can only answer part of the first question -- is the test trustable.  I think it is very trustable.  On my resistance test two years ago, they listed every HIV drug on the left hand side of the page, the mutations which would render this drug  less effective in the middle of the page and then a note indicating whether or not I'd be resistant to that drug on the right hand side of the page.  It is not always clear cut, however.   I was told I had "probable" resistance to a whole class of drugs and couldn't take Atripla.  So, if I were you, I'd get the money together and get the test done.  It will help your physician prescribe medicines that work.  In my case I wanted Atripla but was probably resistant to it.  So the doc put me on Reyataz/Truvada/Norvir which worked. 

Offline nomatterhow

  • Member
  • Posts: 48
Re: Resistance test
« Reply #2 on: December 28, 2011, 01:13:51 PM »
I live in France and a complete resistance test here costs around 400-450 Euros , which is around 650-700 USD ... I did the same test but I was luckily covered by my insurance, I guess in Germany or UK its approximately the same price due to EU laws ... maybe Portugal is cheaper but not sure. and yes they are reliable !

Offline nomatterhow

  • Member
  • Posts: 48
Re: Resistance test
« Reply #3 on: December 28, 2011, 01:19:14 PM »
BTW, 4-6 weeks to get your CD4 results is extremely long ... you should get the results in less than a week , in some urgent cases you can have it over 2-3 days ... resistance test takes a bit longer but not 4-6 weeks . maybe you should talk to your lab

Offline Valmont

  • Member
  • Posts: 332
Re: Resistance test
« Reply #4 on: December 28, 2011, 06:48:08 PM »
Thanks for your answer, each one helped me a lot...  I believe it is important to do it.

About my lab...   Well, here it is impossible to get a CD4 result in less than 2 weeks when everything works well (no problem with machine and so on...); I did not even know that they could be ready in less than a week...  Actually, they say there is a lack of reagents and Iīm not sure I will have them before my doc meeting... 

I also asked to my lab why they did not put % CD4 in the results, they answered me in a very bad form that here doctor donīt need them, so that was why they donīt and wonīt put it.

Nomatter, where can this test be done in France, do you know if it is possible out of Paris?  Do you have to make an appointment for that (how long before) or you just arrive and do it?
Apr 2011: Diagnotized
Jun 2011: CD4: 504  VL: 176.000
Dic 2011: CD4: 714  VL: 95.000
May 2012: CD4: 395 VL: 67.000
Jun 2012: CD4: 367
Agu 2012: Starting Emtricitabine 200 mg / Tenofovir 300 mg and Efavirenz 600 mg (2 pills) different brands or VIRADAY/ATRIPLA/Mylan....
Sep 2012: VL: 138
Dic 2012: CD4: 708 VL: <34  %CD4: 32%
Jan 2013: CD4: 707 VL: <20
May 2013: CD4: 945 VL: <34 %CD4: 33%
Agu 2013: CD4: 636 VL: <34 %CD4: 50%
Dic 2013: Latent TB, started Isoniazid

Offline walkingpoz

  • Member
  • Posts: 33
Re: Resistance test
« Reply #5 on: December 28, 2011, 07:54:53 PM »
I live in Austria and what nomatterhow said applies here too. My doc said the resistance test would be 500 Euros if I had no insurance. Here you need an appointment and it usually takes at least two weeks to get an appointment.
10/11: CD4 554, VL 20,893
01/12: CD4 480, VL 104,000
02/12: started isentress+truvada
03/12: CD4 ?, VL 105
04/12: CD4 632, VL UD
06/12: CD4 495, VL UD
09/12: CD4 ?, VL 60
10/12: CD4 790, VL UD

Offline tednlou2

  • Member
  • Posts: 4,887
Re: Resistance test
« Reply #6 on: December 29, 2011, 12:14:04 AM »
1- I read that these tests are not so trustable.  Is that true? 

It could be what you've read is that a resistance test may not show archived resistance.  I've heard people talk about this--where there could be resistance that has gone dormant and you won't know until you begin meds and see if that resistance pops back up.  The more educated folks here may give some info on whether this is true, and how often it occurs.  When I heard people talk about this, I asked, "I could think certain drug regimens were good and later discover I actually do have resistance to those meds that didn't show up on the test?"  It must be rare, I would think.  Again, it would be interesting to hear from the forum experts on this.   

Perhaps this is what you've read.  Regardless, it is always good to have a resistance test done. 

Offline nomatterhow

  • Member
  • Posts: 48
Re: Resistance test
« Reply #7 on: December 29, 2011, 12:50:33 AM »
I not think you need an appointment , but you have to have your test prescribed by a French doctor which is an easy matter to do , I doubt if you can get a resistance test done by just dropping by without a prescription ... I did it in Paris but I guess in any city of decent size you can do it, and if they can't they still take your blood sample and send it to the nearest center and you pick up your results where you did it ... You can also ask them to fax the results to your doc

Offline Rockin

  • Member
  • Posts: 494
Re: Resistance test
« Reply #8 on: December 29, 2011, 09:31:24 AM »
In Brazil (at least in Rio) this test is pretty basic, every doctor prescribes it. It is quite expensive apparently but my health care covered it, thank god.

Offline Valmont

  • Member
  • Posts: 332
Re: Resistance test
« Reply #9 on: January 03, 2012, 12:57:33 PM »
Ok, thanks, the situation is clearer...  Iīm waiting for my CD4 and VL result to decide, if they are good, I will wait and do this in France; if not and I have to start treatment, I will do it here...


To tednlou2
Yes, that is what I read and I believe this happen because the virus has a little life time and can mute easily, or because resistant virus is but in so low concentration in regard to the rest that this proof donīt detect it and starting treatment it is the only that stay and get mayoritary...
Apr 2011: Diagnotized
Jun 2011: CD4: 504  VL: 176.000
Dic 2011: CD4: 714  VL: 95.000
May 2012: CD4: 395 VL: 67.000
Jun 2012: CD4: 367
Agu 2012: Starting Emtricitabine 200 mg / Tenofovir 300 mg and Efavirenz 600 mg (2 pills) different brands or VIRADAY/ATRIPLA/Mylan....
Sep 2012: VL: 138
Dic 2012: CD4: 708 VL: <34  %CD4: 32%
Jan 2013: CD4: 707 VL: <20
May 2013: CD4: 945 VL: <34 %CD4: 33%
Agu 2013: CD4: 636 VL: <34 %CD4: 50%
Dic 2013: Latent TB, started Isoniazid

Offline Valmont

  • Member
  • Posts: 332
Re: Resistance test
« Reply #10 on: January 11, 2012, 03:41:38 PM »
I wrote to a lab in France one here kindly gave me the adresse...

They asked me about which genotype I need: classic or tropism ("classique ou tropisme", in French), Iīve no idea about that and my doc seems to be in the same condition... 

Can anyone help me with what is usually done?
Apr 2011: Diagnotized
Jun 2011: CD4: 504  VL: 176.000
Dic 2011: CD4: 714  VL: 95.000
May 2012: CD4: 395 VL: 67.000
Jun 2012: CD4: 367
Agu 2012: Starting Emtricitabine 200 mg / Tenofovir 300 mg and Efavirenz 600 mg (2 pills) different brands or VIRADAY/ATRIPLA/Mylan....
Sep 2012: VL: 138
Dic 2012: CD4: 708 VL: <34  %CD4: 32%
Jan 2013: CD4: 707 VL: <20
May 2013: CD4: 945 VL: <34 %CD4: 33%
Agu 2013: CD4: 636 VL: <34 %CD4: 50%
Dic 2013: Latent TB, started Isoniazid

Offline nomatterhow

  • Member
  • Posts: 48
Re: Resistance test
« Reply #11 on: January 11, 2012, 06:49:14 PM »
Hi Valmont !

Do both!!! Tropism is to decide if they can put you on entry inhibitors which is good if you have extensive resistances ( like me ) ... Also ask to do an Integrase inhibitors resistanse test ... If you did it in France ( where I did too ) they normally should do it!

It might cost a bit more but it saves you from the hassle of taking a medication over long time which might have no effec ( except for side effects!!!)
Good luck x

Offline Valmont

  • Member
  • Posts: 332
Re: Resistance test
« Reply #12 on: January 11, 2012, 07:01:31 PM »
Ok, good advises, many thanks Nomatter...
Apr 2011: Diagnotized
Jun 2011: CD4: 504  VL: 176.000
Dic 2011: CD4: 714  VL: 95.000
May 2012: CD4: 395 VL: 67.000
Jun 2012: CD4: 367
Agu 2012: Starting Emtricitabine 200 mg / Tenofovir 300 mg and Efavirenz 600 mg (2 pills) different brands or VIRADAY/ATRIPLA/Mylan....
Sep 2012: VL: 138
Dic 2012: CD4: 708 VL: <34  %CD4: 32%
Jan 2013: CD4: 707 VL: <20
May 2013: CD4: 945 VL: <34 %CD4: 33%
Agu 2013: CD4: 636 VL: <34 %CD4: 50%
Dic 2013: Latent TB, started Isoniazid

 


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