To take failed drugs

[Guest guest]

This is an interesting question that is getting lots of attention.

Viruses that have resistance mutations are less " fit " than " wild type "

virus, and replicate more slowly, and possibly, do less damage. If

you withdraw drugs, wild type can re emerge, and get more disease

progression

On the other hand, removing drugs eliminates the toxicities of drugs,

and the expense and nuissance of them, as well.

My personal feeling is that if possible, remaining on drug is probably

the best option, for now.

JB

On Mar 16, 2004, at 7:01 AM, lipodystrophy wrote:

> Just a question wondering if taking something is better than nothing.

[Guest guest]

I agree that staying on a failing regimen is a good idea, BUT only in people who have no other antiretroviral options. If you stay on a regimen, then you will accumulate secondary mutations and that is acceptable if you have no other options. But if you have options then you should switch to those new options if you think you can get viral control. What you want to avoid is getting secondary mutations to drugs that are still in the pipeline.

José sousa

[Guest guest]

I agree totally, and thank you for clarifying my note.

JB

> I agree that staying on a failing regimen is a good idea, BUT only in

> people who have no other antiretroviral options. If you stay on a

> regimen, then you will accumulate secondary mutations and that is

> acceptable if you have no other options. But if you have options then

> you should switch to those new options if you think you can get viral

> control. What you want to avoid is getting secondary mutations to

> drugs that are still in the pipeline.

> José sousa

[Guest guest]

I agree totally too, and I'd amplify that even more: I don't even

count the drugs in the pipeline. Cuz to be cautious, we can't really

count on them.

I want at least a few in the stable of drugs NOW available, before I

give up on the " failed " drugs I'm on now that are still working, even

with resistances.

>

> > I agree that staying on a failing regimen is a good idea, BUT

only in

> > people who have no other antiretroviral options. If you stay on a

> > regimen, then you will accumulate secondary mutations and that is

> > acceptable if you have no other options. But if you have options

then

> > you should switch to those new options if you think you can get

viral

> > control. What you want to avoid is getting secondary mutations to

> > drugs that are still in the pipeline.

> > José sousa

[Guest guest]

Because you are worried about the present drugs and not the ones in the pipeline all the more reason not to stay on a failing regimen when you have present options. For example if you continue on nukes you are increasing your chances of getting the 151 mutation. This mutation makes your virus resistant to ALL nukes that we have. So would I stay on a failing regimen even if I had other options. NO because I am increasing the chances of getting the 151 mutation, the 69SSS mutation is another worru because it also confers resistance to all the other nukes. Keep in mind though that these matations occur infrequently. I don't remember the statistics for the 69SSS mutation associated with D4T but the 151 is only present in about 3% of people who failed nukes. But to me it is still a risk and if I had another treatment option I would switch. Hopefully it would buy me enough time till another drug (Hopefully several other drugs) comes along.

José Sousa