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HIV AIDS -
HIV and Aids Medication Guide
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Written by Administrator
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Monday, 15 May 2006 |
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If you are resistant to many anti-HIV drugs from more than one drug class, then you might find it harder to assemble a drug regimen which will get your viral load down to undetectable levels.
But it’s still worth taking
anti-HIV treatment. Even if your treatments are unable to achieve an
undetectable viral load, your health is still likely to benefit. If you have
limited treatment options, your CD4 cell count might be a better tool to assess
the effectiveness of your treatment. Finding a new treatment regimen that will
increase your CD4 cell count, your health, and your quality of life is likely to
be a better option than trying to assemble a combination to control your viral
load.
If you are resistant to drugs from all three main classes of anti-HIV drugs (NRTIs,
NNRTIs and protease inhibitors), doctors often say you need ‘salvage therapy'.
The more new drugs you can add to a combination, the more likely it is that your
salvage regimen will work. Resistance tests should be used to help determine
which drugs will work best for you. Tests to measure the amount of anti-HIV
drugs in your blood may also be useful to ensure that you are taking the most
effective dose of your medication.
If your HIV is resistant to a number of anti-HIV drugs, you may find it
difficult to assemble a new regimen which can lower your viral load to
undetectable levels. The aim of treatment should be to maintain or increase your
CD4 cell count and to prevent you from becoming ill. Many doctors now also think
that, newer drugs mean that it is possible to suppress viral load to
undetectable levels and keep it there even in people who have taken many
anti-HIV drugs before.
Structured treatment interruptions are not recommended if you are taking
'salvage therapy.'
If you are not at risk of rapidly becoming seriously ill because of HIV (for
example you have a CD4 cell count above 100 which is not falling quickly) then
you may wish to consider waiting until enough new drugs are available to give
you a chance of getting your viral load below 50 for a sustained period before
you start taking a new combination of drugs. Some people in this situation have
been put on 3TC (lamivudine, Epivir) as a single drug. This is because
resistance to 3TC seems to stop more extensive drug resistance developing.
Doctors should not add a single drug which works into your combination to get a
short-term reduction in your viral load.
Use of T-20 and tipranavir or TMC114
T-20 (enfuvirtide, Fuzeon) belongs to a new class of anti-HIV drugs
called fusion inhibitors, and has been licensed for use in people who have very
few treatment options. Unlike all the other anti-HIV drugs, T-20 needs to be
injected, twice daily under the skin.
Trials have shown that the protease inhibitor tipranavir (Aptivus)
combined with T-20 and other drugs which a resistance test has shown still work
achieves the best results. Very good results have also been seen when T-20 is
used with the as yet unlicensed protease inhibitor, TMC114.
If you are taking T-20 and it is the only anti-HIV drug that you are sensitive
to, then you’ll rapidly develop resistance to it. But even in these
circumstances if you have a very low CD4 cell count and no other treatment
options, it might prove to have some benefit.
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