A question about drug resistance (out of curiosity)

[fabio]

If,let's say,someone had an hiv resistance to an hiv drug. Does he remain like that for life? Does the medication become useless for him forever?
I was wondering about this all the time I hear drug resistance.

[Jim Allen]

Well, basically consider it a yes.

There is a poz lesson written on HIV drug-resistance if you are looking for info.
https://www.poz.com/basics/hiv-basics/hiv-drug-resistance

You are taking Rezolsta & Truvada right? Is this really just wondering about resistance or is it more a concern you have?

If it did happen to first-line treatment, the good thing is that second-line treatments are also very effective and can be well tolerated,and vise-versa. Look if you have good adherence and you are talking your HIV medications every day, you should not be worrying though, if that's is a concern you are having.

My guess would be you are far away from being multi-drug resistance. My own ID doctors thoughts he shared on this and he's only been doing this since 28 years, is its not the odd forgotten pill in a blue moon that is the issue with adherence , its people taking mini "holidays" from meds, the continued stop/starting of treatment.

You might get away with it a few times or even more but sooner of later it causes nothing but tears

Jim

 

[fabio]

Oh don't worry haha. I take my meds perfectly. I just hear "resistance" and I was curious.
As of now I feel really comfortable. I also decided to not spend new years alone. I'll go to my grandparents.
I'm just so greatful that I truly feel happy and hopeful,I feel much more independent than before.
Also thank you so much for the link.

[fabio]

Oh I am using those. It's weird they got other names here and in other places  (comical actually) mine look like female and male viagra combined haha.
In general I don't really miss anything,but even if I do in every "once in a blue moon" I won't panic. My docs are actually quite happy with my progress.
What helps a lot is that my parents and brother know and I won't have to hide to take the pills. I have them reminding me,my watch,my phone and generally a good memory...😅😅

[Jim Allen]

You're welcome and glad to hear that your family are supportive

It's weird they got other names here and in other places  (comical actually) mine look like female and male viagra combined haha.

I'm convinced the names of the medication is some twisted bio-geeks pharma joke conspiracy, just so they can watch and listen as the rest of the world struggles pronouncing them   

Mine looks like some toddler glued 3 pills together one morning whilst not paying attention and said "Look what i did daddy"  Anyhow I won't complain too much as the elephant sized pill a day does keep the AIDS away.

Jim

[fabio]

My mom was very worried,but now she is seeing herself I feel and am better.
Personally I take things that happen to me as a lesson. Both the good and bad are bound to happen,but even if I'm sad I am now sure I can pull through without being I've emotional haha. I also talked to a support group on phone and they helped me figure stuff,and of course the forum helped me a whole lot.
My only worry now is applying for uni next year haha.

[Jim Allen]

Support groups can be really good, and more people should use them.

University  . What's are you going to be studying? If you say medicine, ill just say upfront that ill be expecting free medical advice for life after you graduate 

My mom was very worried

Mothers always worry, its part of the job 

Jim

[fabio]

Oh medicine is too hard haha. I wanna study social  work.
It might not be so fancy,but it's something I feel like suits my own needs.
I will be finishing next year my hotel management course (for a safe net job) and then start with social work. I want to focus more on inmates and people who have serious health problems,the impact these things have in their lives,people who suffer from drug abuse. I certainly dont want to have to do with kids though haha,I just don't know how to communicate with them haha.

[Jim Allen]

Social work, okay cool, very noble.

Take it easy and hope you have a great New Years with your grandparents.
Glad you are not spending it alone.

Jim

[leatherman]

Does he remain like that for life? Does the medication become useless for him forever?
I was wondering about this all the time I hear drug resistance.

drug resistance was more of a problem in the earlier days when the med half-lives weren't as long and when the side effects were much worse (causing people to be less than 93% adherent).

while most all resistance issues are for life (once the HIV mutates to adapt against that drug, the hiv retains that mutation); there are a few mutations that are even too much for HIV. For example. a resistance to epivir causes a mutation that doesn't allow HIV to make viable copies, so within a few yrs, the epivir-resistant mutated HIV virions die off, and viola! epivir is a viable medication again for the patient.

[fabio]

So it's kinda how antibiotics react to other micro organisms (except viruses).
So epivir can be used again after a period of time?
The good thing is that even if something like that happens people still have choices. But,I guess eliminating the possibilities of getting resistance is better than the other choices.....

[leatherman]

The good thing is that even if something like that happens people still have choices. But,I guess eliminating the possibilities of getting resistance is better than the other choices.....

remaining adherent to meds and not developing any resistance is really the only good choice.

Developing resistance means multiple meds along with the higher cost, higher pill burden, multiple dosing times and restrictions, increased medical monitoring, increased negative side effects, and more fear, worry and stress.

in the early years of HIV treatment, resistance could even mean you had no meds that would work and you simply had to wait (while hoping to not die) until another med would come to market, or it could mean that you were on a "salvage regimen" of 6 to 10 meds in an effort to suppress HIV.

Twice in my life, I had to go nearly a year (while very sick) waiting on a new medication to come to market (hoping I didn't die with AIDS). It wasn't until integrase inhibitors were developed that I was able to switch off my 8 medication salvage regimen. Trust me, resistance is easy to avoid these days (stay at least 95% adherent), and well worth your time and effort. Not having any meds that work properly against HIV is a terrible position to be in.



btw back in Nov, I celebrated living with HIV for a total of 34 yrs and tomorrow (12/26) is my AIDSaversary and marks 26 yrs of AIDS and meds