Thanks for your question and for allowing to post the answer online so other people can benefit from the information.<\/p>\n
I’m sorry to hear that you were having such a difficult time last year which brings up several important points.<\/p>\n
The first is that your feelings of desperation, and the decision to take an overdose, may have been related to the Sustiva (efavirenz) in your combination. Mood changes are associated with this drug and in a small number of people this has been linked with suicidal thoughts and actions.<\/p>\n
It is difficult to separate your own feelings and the impact efavirenz had, but this may be a good reason to be cautious of using efavirenz in the future.<\/p>\n
Your doctor should have highlighted this as a possibility to explain what happened, and why you had such a difficult time.<\/p>\n
Secondly, increasing the dose of any HIV drug will not increase any risk of resistance. If anything, it may have made the combination more powerful for that week and made resistance much less likely. The risk of resistance some when drug levels become to low, often because of missing of being late with ARV doses.<\/p>\n
Your CD4 count of 190 was actually pretty strong and just below the level that used to be recommended for starting treatment. Over a third of people in the UK are diagnosed after their CD4 count has dropped below 200, and while this is not ideal, most people do very well once they start treatment.<\/p>\n
Also, the T215S mutation, while showing a possible reduced sensitivity to AZT, wouldn’t really limit your treatment options, especially as AZT isn’t widely used now in first-line therapy.<\/p>\n
A technical reference to this is included below in case this is of interest.<\/p>\n
It is great that you are feeling better now and that your new combination is working well.<\/p>\n
Thanks also for the nice feedback, which is always appreciated.<\/p>\n