April 18, 2010

April 18, 2010
Aloha Honolulu

Welcome to another day in my life. Today is Sunday and I hope you are having a safe and great weekend so far. It is a beautiful day here and I hope it is where you are also.

Today Dab the AIDS Bear is doing the AIDS Walk Honolulu in Hawaii. The walk began this morning at 9am at Kapiolani Park. Everyone here is so friendly for which Dab the AIDS Bear and I are very thankful. It is great to see another community who really cares about people with HIV and AIDS. I hope to have the pictures processed and posted in the next several days.

I told you yesterday my ex, Gary, is in the hospital. I received a message from him saying he will hopefully be out soon. But he still has not said what the doctors had to say about the problem. So I am still waiting to find out. So stay tuned for more details on that.

I have been talking about resistance in the past couple of blog and will continue the same theme today. Today I will be talking about cross resistance.

Once resistance to one anti-HIV drug has developed, this may mean that your HIV is also resistant to other, similar anti-HIV drugs you have not yet taken. This is called cross resistance.

Cross resistance can affect all the currently available anti-HIV drugs to some extent. However, cross resistance is not inevitable if you develop resistance to one drug, and the use of resistance tests will help you and your HIV doctor select the anti-HIV drugs that are likely to be most effective against your virus if resistance does develop.

Resistance tests

Blood tests are available which detect whether the HIV in your body is resistant to anti-HIV drugs.

It is recommended that drug resistance tests are used when a person is first diagnosed with HIV in case they have been infected by a virus which is already resistant to one or more drugs. It is also recommended that everybody who is about to start HIV treatment for the first time should have a resistance test. You should also have a resistance test whenever you are changing treatment because your viral load is detectable.

Resistance tests are also recommended to help guide the choice of treatment in women who are pregnant, and in children.

Results should be interpreted by someone who is experienced in their use. Test results should be considered alongside a full treatment history, rather than in isolation. This is because drug resistance is not the only reason why HIV treatment can fail missed doses, poor absorption and drug interactions are other possible causes to consider.

Resistance tests can now be done if your viral load is above 200 it used to be the case that you had to wait until your viral load was 1000 or more before they could produce accurate results.

Resistance tests will also be more accurate if done while you are still taking a failing combination rather than after you've stopped it. Once you stop taking a drug, the sensitive viruses start to grow rapidly as they are usually more fit than the resistant viruses. The test may give the wrong answer as it may not be possible to detect the smaller number of resistant viruses.

There are two main methods of testing for HIV drug resistance:

* Genotypic tests which look for specific mutations in HIV's genes that are known to be linked with resistance to anti-HIV drugs.
* Phenotypic tests which measure the concentration of a drug required to reduce viral replication by a set amount. When resistance to a drug begins to develop, higher levels of that drug will be required to stop HIV growing.

There is no clear indication that one type of test is more useful than another at the moment each has its pros and cons.

So your goal is always to keep your viral load either undetectable or as low as possible to avoid resistance. More on this topic tomorrow.

Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug,

Daddy Dab