Meds, Mind, Body & Benefits > Questions About Treatment & Side Effects

AZT Resistance Question and Others

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BigPlans:
Hello - I was just diagnosed 2 months ago and have never had any kind of treatment.  My doctor did a "genotype" or something and it showed some resistance to AZT.  I've tried to look that up, but I'm not sure what that means?  I know it means that they won't use AZT when I start treatment.  But is it a horrible thing?  Nothing to be particularly concerned about? What exactly?  Are other medications just as effective for those first going on treatment?  Any help would be appreciated.

The doctor is considering starting treatment even though my T cells are in the low normal range and my VL is <3,000 - because I've had constant diarrhea for 5 months now (started after taking a round of antibiotics for pulled tooth).  As long as I take something (pepto, immodium or lomodil) my stomach is perfectly normal.  He said that because we are trying to stop the diarrhea and not as concerned with the levels, that it may be okay to start treatment, get my stomach on track and then stop again.  I know that most things I'm reading say that once you start, it's better to keep going.  Anyway, I'm very new to all this and if anyone else has expertise or can explain the AZT resistance and if it is something that I should be very concerned about?

Also - is there anyone else who has struggled with diarrhea before starting treatment?  My doctor gave me a study which seems to suggest that it is "an immunte reaction mounted in the mucosa by the host against its own HIV infected cells".  I'd like to hear if anyone else had this initital reaction and if the diarrhea corrected itself or if you started treatment for that.
Thanks!
BigPlans

Tucsonwoody:
Hello BP -

I am no expert - having just been recently diagnosed, but am learning almost everyday.  From what I understand a genotype test tells your doctor what  medication to avoid because it will not be effective for you.

Because I had some "OI's" or opportunistic infections I couldn't start HIV treatment until they were under control which is similar to what your doctor is doing in trying to stabilize you before starting an HIV med. I was/have been lucky not to have the diarrhea problem yet so can't say much about that.

When I met with my doctor to discuss my AIDS treatment she said my genotype indicated that I had no resistance to any of the HIV meds...at least not yet.  She also went through all the medications and we decided to start me out on Atripla, which for me has worked well as far as side effects so far.

As you can see from my numbers below - I should be dead really since I have such a low CD4 count (which has actually improved and that was before I started on Atripla) and a really high viral load.

From what I know about the medications, it isn't uncommon for us to start with a resistance to some or develop a resistance as time goes on and have to change.  There are quite a few choices for you to try other than AZT I would guess. 

As you read more of the forums you'll see a lot of references to people who have had to switch from one medication to another as their bodies have developed a resistance to the medication.  It is pretty individual though as I have seen people who have had the same meds for over 10 years.

Anyway like I said I still have a lot to learn and this is pretty good place to get information.  I am sure others will have better feedback for you.

I wish you good luck and hope you're able to get the information you need - like they say, fear of the unknown is one of the hardest things to deal with - so arm yourself with as much info as you can.

Kevin

gerry:
It would be helpful to know what exactly the genotype showed to make an assessment of how extensive (or not) the resistance is.  If it's really just AZT resistance, there are several other options to choose from.  But the other thing to remember is some resistance generated against AZT may cause cross-resistance to other nukes.  That's why it's important to know the actual resistant genotypes in order to make that determination.

sdcabincrew74:
I had diarrha for about 2 years before starting meds.  Of course, I did not start meds until I was discharged from the hospital after a bout of PCP and MAC.  My CD4 was 22 and 2% and my VL was off the scale.  Since my numbers have bounced back VL = undetectable and cd4 of 450 and 22% all my gastrointestinal issues are gone! 

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