Question

HIV meds have run out in Romania – will I get resistance?

27 August 2021. Related: Access to treatment, All topics, Stopping treatment, Support.

Hi. I’m from Romania, and due to the lack of allocated funds, I no longer receive ARVs.

It has already been two weeks since I took the last dose, I am afraid that my viral load will rebound.

My doctor told me that they can’t do anything, until the Romanian Ministry allocates the necessary money for medicines.

Is it possible to develop drug resistance to Triumeq in this time?

What should I do? I’m very stressed about this.

Answer

Answer: Simon Collins

Hi there.

Thanks – this is very bad news and I am sorry for everyone in Romania who is in this situation.

I hope that the publicity from writing about this case might pressure the Romania government to fix this.

You are right that without treatment, viral load will rebound. This will probably happen 2-4 weeks after stopping. It is also likely to return to about the same level it was before you started treatment.

Although this is not good, you are not likely to have developed resistance. This is because all three meds in Triumeq will have left your body together at the same time, limited the risk of resistance. You cannot develop resistance now that you have stopped treatment.

The main risk relates to your CD4 count before you started treatment. The higher this was, the less risk of any short-term problems, especially if this was above 350 or 500.

If your CD4 count dropped to below 200 though, your doctor should give you antibiotics to protect you until treatment is available again.

If it dropped much lower than 200, especially to lower than 100, your doctor should find out if there are other combinations you could use. This might include contacting different drug companies for compassionate access where they give you the drugs free.