Question
I missed 2 pills, am I at risk of drug resistance?
7 March 2022. Related: Adherence, All topics, CD4 and viral load, Resistance.
I am on HIV treatment for the last 4 years. I never missed a single dose. Presently I am taking TLD. My viral load is undetectable and CD4 count is 1091. But in last 90 days I missed 2 pills only. Is there any chance of drug resistance for those missed 2 pills?
Answer
Hi, how are you doing?
No there is no chance of drug resistance after missing 2 pills. Drug resistance is rare, even in cases whereby people miss weeks – months of their medication. 2 pills (2 days) is not going to risk resistance.
HIV medication maintains a high half life and takes longer than 24 hours to be removed from the body. This means that even is a dose is missed it is likely you will have enough drug in your body to work.
Resistance would also require viral rebound. This can take up to a week if you are undetectable at the point of stopping medication. In 2 days viral load can not rebound to a degree high enough to risk resistance.
As you are undetectable and you have an excellent CD4 count, it indicates that your medication is working very well. There is no risk of drug resistance.
Josh.
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