Question
What do you think about drug resistance, fitness and transmission?
12 November 2021. Related: All topics, HIV transmission, Resistance.
Hello I have been positive for 30 yrs and have been undetectable for the last 17 yrs, I do have resistance to some ARVs medications.
I have read an article online about resistance. In this article it stated that “Typically, the more that HIV mutates and develops resistance to a broad range of ARVs, the less “fit” it becomes” —meaning it does not replicate or transmit as effectively.
What are your thoughts?
Answer
Hi there
Thanks for some great questions.
You are right that some drug resistance mutations also make HIV less fit. The changes that makes the drugs stop working can also stop the virus from reproducing so well. Unfortunately, this only lasts for a short time though as additional mutations usually overcome this and make the virus fit again.
This doesn’t directly affect your situation though.
This is because your viral load has been undetectable for so many years. This means that the drug resistance that developed on your first combinations is also suppressed.
Your HIV is still sensitive to all your current drugs and the old resistant HIV is only likely to be in a few sleeping cells. So long as you keep taking meds the old drgu resistance will not be a problem.