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Author Topic: Successful ART zeroes possibility of Resistance?  (Read 1765 times)

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Offline konpisces

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Successful ART zeroes possibility of Resistance?
« on: November 06, 2021, 08:40:43 am »
Hey all, hope you are doing fine!

I was wondering the following: i've read that remaining more than 6 months UD since first diagnosed as UD means you are durably UD. Is there a possibility that even at this state, the virus will find some way to mutate so that it can evade the current (successful) ART treatment?

Offline konpisces

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Re: Successful ART zeroes possibility of Resistance?
« Reply #1 on: November 06, 2021, 08:41:45 am »
The assumption is that the HIV+ person is fully adherent to the therapy - not missing doses.

Offline Tonny2

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Re: Successful ART zeroes possibility of Resistance?
« Reply #2 on: November 06, 2021, 09:11:05 am »




           ojo.        Hi!…welcome!…I’ve been on the same treatment for 14 years, still UD, even though I had a history of resistance. (If you want read “hope dies last”, my thread…just take your med/s as prescribed and the chances of becoming resistance there are lots of options to switch to…good luck

Offline Jim Allen

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Re: Successful ART zeroes possibility of Resistance?
« Reply #3 on: November 06, 2021, 09:32:10 am »
Let me put it like this, once you have suppressed the virus and continue to take your meds correctly you should fully expect your viral load to remain suppressed.

So keep taking your meds and go to your check-ups to monitor.

https://www.poz.com/basics/hiv-basics/hiv-drug-resistance

P.s

Know you only recently started treatment. When is your next follow up appointment?

Keep posting any questions or concerns you have but also write them down to ask your doctor when you next see them.
« Last Edit: November 06, 2021, 10:32:43 am by Jim Allen »
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Offline leatherman

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Re: Successful ART zeroes possibility of Resistance?
« Reply #4 on: November 06, 2021, 11:09:01 am »
here's something I posted back in August

the take-away is when a patient remains adherent to ARVs the conditions are not conducive to HIV mutating.

Resistance (HIV mutating to resist a medication) mainly happens from not taking enough meds properly. The amount of virus has to drop to low levels, but not be totally absent, for the virus to mutate against the drug. In other words, someone who takes meds a few days, then skips a few, then takes it for a few more days sets themselves to have the levels of meds dip too low and HIV mutating before bringing the levels back up. Completely stopping meds usually doesn't cause resistance because the level of meds continue to drop well past any level to effect HIV before the HIV can mutate.



I took this chart from a site about antibiotics and edited it a little bit, so please ignore any weirdness there at the 2nd dose. The thing to take away is that any time adherence falls below the point (the red dashed line) of keeping the med level high enough (at least 95% adherence or higher*), resistance becomes possible.

*Thankfully, the meds of today are much more effective. With a longer half-life (the amount of time the med is at the right level in your system), these meds stay in our systems longer, making incidents of non-adherence (skipping a dose) less likely to allow HIV to mutate. This is what allows a greater leeway (2-4 hrs) around the timing of each day's dose, or not developing resistance when missing a single dose in a month.
leatherman (aka mIkIE)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline konpisces

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Re: Successful ART zeroes possibility of Resistance?
« Reply #5 on: November 06, 2021, 11:12:00 am »
Thank you for your replies! Yes, I am on my 3rd week of treatment. No discernible side effects so far.

Next check is after 1 month on treatment.  I will go to the ‘vampires’ in 9 days..

Offline leatherman

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Re: Successful ART zeroes possibility of Resistance?
« Reply #6 on: November 06, 2021, 05:09:26 pm »
just remember: your lab results are just a snapshot of one moment in time. (CD4s can change by 100 pts a day! they're highest in the evening btw. it doesn't really "mean" anything; but it is a slightly interesting factoid) In the long run, you'll want to evaluate your situation by how your numbers are doing based on at least 3, over at least 6 months. Trends are much more meaningful as a diagnostic tool, than a single test ;)
leatherman (aka mIkIE)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

 


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