Question
How often can I miss a dose?
9 June 2008. Related: Adherence, All topics, Resistance.
Hi, I have been on Sustiva/Truvada for 7 months and only missed 1 dose.
In your opinion how often could you safeley miss a dose? Not intending to purposely miss doses just a question really. Thanks!
Answer
I have a very traditional opinion and will have to say that you cannot miss doses safely.
The thing is that HIV does not mutate selectively, it does it randomly. Hense missing a dose is like a Russian roulette. During the period when the virus can replicate (as there is not enough medication to supress it in your body), it can mutate in such a way, that it becomes resistant to the medication, but it also can mutate in a way that it does not become resistant.
Hence every missed dose is a potential resistance provoker and it is more true with the non-nucleoside reverse transcriptase inhibitors (Sustiva and Viramune) than with the protease inhibitors.
At the same time, as I mentioned before, not every missed dose will by default lead to resistance, but, again, less is better.
Hi Mason,
If your viral load’s ok then its very likely that the CD4 result was just a blip. However its worth seeing if you can have it retested. With regards to the antibiotics you should ideally take these until your CD4 is 200, if not 350 depending on what your doctor recommends.
Hi lisa my last viral load came out less than 20 but my cd4 cam out 164..am worried about the cd4 what could be the cause of the decrease ? Could it be an error in the test ..and secondly when do i stop taking the antibiotics or is never stopped?
Hi K,
Its highly unlikely that your viral load will increase, this is because it usually takes a few weeks for a persons viral load to increase.
I’ve been on medication for about 2 years now and I fear that I may miss a dose for 2 to 3 days because of a mailing error and I fear that my strain will become resistant. I am undetectable and want to know what are my chances of the drug no longer working? I hate our mailing system and people not keeping their word.
Hi Lora,
Its very unlikely that you missing 2 doses will cause you or your baby any problems. How long have you been on meds for?
Hi there, my viral load is 163. How will missing 2 doses affect my breastfed Hiv negative baby?
Hi Kolade,
Please see Q4 here:
http://i-base.info/qa/what-are-the-most-asked-questions
I was 3 hours late with my medication, will I be OK?
Hi Ziyanda,
You missing one dose won’t influence the risk of transmission. Also if you’re on meds and your viral load is undetectable you can’t transmit HIV through sexual intercourse. Please see here for more info:
http://i-base.info/htb/32308
Hi…. just wanna ask if missing a dose and have unprotected sex with HIV negative person what are the chances for him to be infected more especially if his isn’t circumcised.