title: [New therapeutic options in protracted HIV-infected patients with virological failure].
abstract: Once patients have a triple class virological failure, their treatment options are limited and there is an increased risk of death. In order to construct active treatment regimens, new potent antiretroviral agents are available for these patients. The virological target in patients with treatment failure is now plasma HIV RNA level below 50 copies/ml when 2 or more potent drugs are identified. If at least two active drugs cannot be identified, the current regimen should be maintained until new drugs become available, assuming that there is an immunological and clinical stability, in order to avoid the use of a single-active drug that usually leads to rapid development of resistance, further limiting the future treatment options. In this article, the current state of knowledge about these new agents available and the guidelines of main societies are reviewed.
authors.affiliation: Unidad de Infección VIH, Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España. vjmorenocuerda@yahoo.es
authors.forename: Víctor Julián
authors.initials: VJ
authors.lastname: Moreno Cuerda
authors.forename: Rafael
authors.initials: R
authors.lastname: Rubio García
authors.forename: Montserrat
authors.initials: M
authors.lastname: Morales Conejo
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000069454:Darunavir; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D000077560:Enfuvirtide; D006678:HIV / Q000187:drug effects / Q000235:genetics; D015700:HIV Envelope Protein gp41 / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D023581:HIV Fusion Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D009930:Organic Chemicals / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D010446:Peptide Fragments / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011725:Pyridines / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D011753:Pyrones / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D011760:Pyrrolidinones; D012367:RNA, Viral / Q000032:analysis; D000068898:Raltegravir Potassium; D016032:Randomized Controlled Trials as Topic; D013449:Sulfonamides / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents; D015700:HIV Envelope Protein gp41; D023581:HIV Fusion Inhibitors; D017320:HIV Protease Inhibitors; D009930:Organic Chemicals; D010446:Peptide Fragments; D011725:Pyridines; D011753:Pyrones; D011760:Pyrrolidinones; D012367:RNA, Viral; D013449:Sulfonamides; D000077560:Enfuvirtide; D000068898:Raltegravir Potassium; D000069454:Darunavir; C107201:tipranavir