Q and A

Question

Will missing meds for 11 days cause drug resistance?

Hi! I missed my treatment for 11 days. I have been on treatment consistently for 2 years now. Should I be worried about drug resistance?

Answer

Hi there

This is a good question that gets asked for different reasons.

Sometimes, even when being careful with meds, treatment can be interrupted. Sometimes from forgetting to take meds when travelling, or running out if you stay longer than planned. In some countries, a pharmacy can sometimes run out – though hopefully this is now rare.

If you only stop treatment once or twice, the risk of resistance is very low. It is also much lower now with modern HIV meds. But if it happens a lot, then all these small risks add up to become larger.

The risk comes during the first couple of days when you stop and when you restart. This is when drug levels are low enough for resistance to perhaps develop.

Sometimes we ask about whether viral load will be high enough to be a risk of transmission to sexual partners.

Luckily, viral load is likely to still be undetectable for at least a week after stopping meds and sometimes longer.

Viral load also usually quickly returns to being undetectable when ART is restarted.

2 comments

  1. Josh Peasegood

    Hi NR, congratulations on having a baby. Before this result of 900 had you had any other abnormally high viral load test results?

    As you have been adherent with medication it makes drug resistance very unlikely.

    Have you been offered a second viral load test? The most common and likely answer is that there was a lab error causing a falsely elevated viral load. Were you ill/had a recent vaccine when you went for this test? Both of these can also cause temporary increases in viral load.

    Before having this result confirmed along with the treatment resistance tests you are having there is no need to be worried.

  2. NR

    Hi.. I have been on ART for 9 years, I got undetectable probably more than a year after starting treatment but I just used the available meds Kivexa and Kaletra, then I was prescribed Abakavir and Isentress and got undetectable, got pregnant and gave birth. My last VL however is going up from undetectableto detectable, now it it around 900. They are going to do a test for drug resistance. Should I worry about it? Is there a lot other options? Why is it so , I adhere perfectly +/- 30min change the time of the doses, never missed a dose …I also have hashimoto disease after birth but doctors said eythyrox is not a problem to take

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