The Friends of AIDS Foundation/Topics/HIV and Drug Resistance

HIV AND DRUG RESISTANCE

HIV medications are designed to help stop the HIV virus from spreading within your body. The
medications work to control your viral load by not allowing the virus to duplicate itself. HIV drug
resistance occurs when the virus can adjust in your body and continue to produce new copies,
despite the presence of HIV medications in your system.

While not all people infected with HIV will develop a resistance to HIV medications, it is wise to
understand resistance and become proactive in taking the necessary precautions to try to avoid it.
The key is to select a treatment regimen that will be most effective in combating the virus. It is
recommended that prior to starting your HIV treatment you speak with your health care provider
about resistance testing. Since not all HIV is the same, it’s possible that you could be infected with a
type of HIV that is already resistant to certain medications. Resistance testing enables you to find out
if you are likely to be resistant to any HIV medications. You and your health care provider can then
use the results of these tests to determine the most effective treatment option. Having this
conversation will allow you to also discuss a range of treatment options should you need to utilize
them in the future.

When your HIV medications are working, they identify and zero in on the HIV virus in your body.
However, sometimes HIV makes errors during its reproduction. These errors are known as mutations.
When the mutated virus reproduces, it can change its structure to the point that the HIV medications
can no longer identify and target the virus. This allows the virus to copy itself more easily, thus
causing resistance. Once resistance has developed, the medications will no longer work effectively
and you will eventually need to switch medications.

After starting treatment, the HIV in your body may become resistant to your medication and you may
not feel any different at first. As the medication becomes less effective, the amount of HIV in your
body can increase, and you may begin to feel sick. Being resistant prohibits your body’s immune
system from working like it should, thus making it easier for you to acquire an opportunistic infection.
Knowing if your HIV is drug resistant is the first step to managing it. There are two types of blood
tests that can assist you in finding out if you have developed drug resistance. A phenotype test
measures how effectively a medication prevents HIV from reproducing itself in your body. A genotype
test identifies the type of HIV mutation that has developed.

It is possible that once resistance has developed to one type of HIV medication, it can also become
resistant to other HIV medications. This is called cross-resistance. If this happens, you may not have
as many options for other HIV medications. Taking preventative measures to prevent resistance is
important for keeping your treatment options open in the future. Your health care provider will be
able to advise you on choosing the appropriate medication to make it more difficult for HIV to develop
resistance.

One of the ways to reduce the risk of developing resistance is to make sure that there is enough
medication in your body at all times. It is important to take your medications every day and exactly as
prescribed. Make sure that your prescriptions are refilled on time so that you do not have a lapse in
doses. If you fail to adhere to your treatment plan, it becomes easier for the virus to develop
resistance.

If you engage in sexual activities, make sure you practice safe sex. There is a possibility of you being
re-infected with other resistant types of the HIV virus. Make it a habit to always use a condom during
sex. It is also recommended, that if you are using needles for drugs or tattooing, make it a practice to
avoid sharing needles.

Remember, being proactive today to prevent HIV drug resistance helps to ensure a healthy tomorrow
and keeps your options open for the future.