Therapeutic options for treatment experienced patients: a focus on resistance testing and optimizing background therapy.
Antiretroviral therapy may fail to achieve virologic suppression for a variety of reasons. When failure occurs, treatment regimens and goals must be carefully reassessed. Even with extensive multiclass resistance, most treatment-experienced patients benefit from continuing or switching regimens rather than discontinuing therapy entirely. Selection of a new treatment strategy is influenced by the presence of resistance mutations; therefore, resistance testing is a crucial part of designing a new antiretroviral regimen. Various clinical trials have confirmed the benefit of such testing and the advantages of individualized and optimized regimens. However, some highly treatment-experienced patients may have few or no remaining treatment options and pose a major challenge to disease management. The development of new agents will be necessary to create highly effective regimens for patients with complicated resistance patterns.
Sax
Paul E
PE
Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D010346:Patient Care Management; D017211:Treatment Failure
D019380:Anti-HIV Agents