POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: scotty54 on March 01, 2013, 10:58:13 am
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Cutting right to the question, Is there any kind of lab test to measure drug resistancy if your viral load is undetectable? After browsing thru many past threads, I think it is probably a no.
A bit of history. Atripla for more than 6 years. Efavirenz difficulties included sleeping disorders/less snap. Complera began 9/2012. Gradual improvement. Efavirenz continues to haunt a bit.....or maybe it is the rilpivirine. Convinced that another regimen (perhaps NNRTI free Stribild.)
I want to take my time and make the right decision when I switch, and if I could get any measure of resistance testing, it would be helpful before I switch.
10/2012 Complera VL UD CD4 624 % 31
Thanks much.
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Hi Scotty . I'm giving your thread a bump to see if we can get a bit more of a technical answer than I can provide . I snagged this off another site as a general guideline to go by , its at least a start at answering your question .
Genotype tests generally can detect mutations in plasma samples with HIV RNA levels of >1,000 copies/mL, but sometimes are successful with viral loads of 500-1,000 copies/mL.
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Are you sure that your doctor didn't do a resistance test years ago before you went on meds? That's generally the course of action.
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Thanks Jeff G and Miss P
I suppose it would have to be an incredibly sensitive and sophisticated geno/phenotype to be able to detect a minute amount (less than 20 copies) of the virus and then separate the even smaller percentile of resistant particles. The technology probably exists, but would be cost prohibitive. At least for me.
Science is amazing.
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If you do decide to change meds and it doesn't work out you can go back to the old regimen , it isn't like its a guarantee you can never take the old one again .
If you make a change and your viral load rebounds then you are in a position to have the resistance test done if your viral load goes >1000 . That's exactly what happened to me when I did a a med change and I went back to Atripla and responded just as well as I did before the change .
I do agree that med changes require careful consideration .
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If you consider a switch to Stribild chances are that it will work out well since you are already on 2/3 active components now with Complera (tenofovir and emtricitabine), excluding the booster cobicistat found in Stribild.
In reality such a switch would mean mean there is only to go from Rilpivirine to Elvitegravir as the 3rd drug( Complera -> Stribild.) Unless you have been on a integrase inhibitor earlier I think its highly unlikely you would have stored resistance to this class of drugs thus the conclusion this switch in particular is likely to go well.
Happy sailing.
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Jeff G Glad to hear your return to Atripla is working for you. Yes, still weighing the considerations on switch, as I believe there has to be a more comfortable regimen for me. Decided to give Complera 6 months and have hit the mark.
Common ground I believe I showed a resistance to Nelfinavir (Viracept) an old PI in 1998, shortly after started treatment. I believe it is rarely prescribed any longer for a variety of reasons, including a recall. Have never taken an integrase inhibitor.
It may be that NNRTI's dont agree with me. Thanks to Ann for suggesting that as a possibility. Appreciate your input.