Management of Treatment-Experienced Patients With HIV
Summary
- After assuring adherence and lack of drug–drug and drug–food interactions, it is important to assess whether the person has a fully active boosted PI and/or second-generation INSTI available
- If either or both of these are available, one can extrapolate from data from first-line NNRTI-based failure that a boosted PI could be used with NRTIs (regardless of susceptibility), an INSTI could be used with at least 1 fully active NRTI, or an INSTI and boosted PI could be used in combination
- For those without a fully active boosted PI, genotypic scores and phenotypic clinical cutoffs have been established for many agents in long-standing drug classes to predict level of drug activity, including newer agents within these classes Selecting Among Available Antiretrovirals
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