Question regarding Resistance

[MoltenStorm]

I'm currently on Atripla, and I was wondering something. Granted, I will be asking my doctor this same question when I see him again, but I thought I'd throw one at you guys first.

I have been 100% adherent. Is it still possible to become resistant even with 100% adherence?

Molten

[fondeveau]

I'm no doctor, but I play one on AM Forums...er..um...I would think it is possible.  Virus is always mutating and present, so there is bound to be one little bugger in there that after ten years or so will make your VL jump unexpectedly and lead to a change in combo?

[Londonguy]

Heh, I made this exact same thread when I first joined.  Basically, yes.  But by adhering 100% you are dramatically decreasing the odds of it happening.

[jack]

yes. I have developed resistance to almost all the drugs(except prezista) and have always been 100% compliant, some PIs in as little as 6 months, the most recent reyataz and kaletra.
I really get pissed when a Dr. insinuates that I haven't been and thats why I am resistant. I have been taking these poisons religiously for 18 years.

[sdcabincrew74]

Yes, contrary to what modern medical science will have you believe, those that are 100% compliant can and do develop resistance to drugs.  In fact, I got my doc to admit to me that resistance develops in about 20% of all folks even if they are 100% compliant.  He had no science to back it up, that was just his experience.  Some do not, AZTECAN is one that I can think of.  However, some also do.  So far, so good for me ... but it is always on the back of my mind....

[Miss Philicia]

Yep.  I had no adherence issues but still mutated against the entire PI class.  It does and can happen, but it's certainly not the most common route by any means so no need to obsess over it.  My doctors finally did start to realize that my diarrhea issues on PI's were above and beyond what was normal and that I probably had been shitting through the medication for 5 years and not achieving optimal levels of them in my blood, and hence why I never could get to undetectable levels on them.  I've met another person who experienced the same thing.  I think some doctors, or at least back in this time period I'm discussing in the late 90's, were kind of clueless about this particular issue and though I complained periodically and forcefully about my runny rear I was never offered more than loperamide.  I probably should have been given tincture of opium the entire time.

On the other hand my best friend who is also HIV+ SUCKS with adherence, has been diagnosed as long as I have (~15 years) and on HAART, and never developed a single mutation.