With any HIV regimen, a major problem can be the development of resistance. When HIV makes copies of itself (reproduces), it can make mistakes, called mutations. Some mutations prevent certain HIV drugs from working. When this happens, we say that HIV has become “resistant” to a particular HIV drug. Viral load can increase quickly if resistance occurs and you may have to switch regimens.
In addition, if you become resistant to one drug, you become resistant to other drugs in the same class. This is known as cross-resistance. The more drugs you are resistant to, the less treatment options you have.
Before starting HIV treatment, it is important that your health care provider gives you a resistance test to find out if you have drug-resistant HIV. This helps determine which drugs will work best for you. The treatment guidelines recommend resistance tests:
- For all HIV+ people when they enter into care
- For those who are planning to change HIV drugs
- For those whose treatment is not working (for example, viral load is going up or not decreasing very much while taking HIV drugs)
- For all pregnant women prior to starting HIV drugs
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