Summary

Introduction

• HIV-infected patients needing to modify treatment due to virologic failure have several highly active and well-tolerated options
• First step in optimizing treatment is defining potential obstacles to success, such as factors associated with poor treatment adherence^{[Chesney 2006]}
• Selecting a new regimen requires determining which agents are likely to be virologically active for a given patient and using them in effective combinations

Principles for Managing the Treatment-Experienced HIV-1-Infected Patient

Defining Treatment Failure
• Treatment failure defined as either of the following outcomes with the most recent antiretroviral regimen:
  • Failure to achieve undetectable plasma HIV-1 RNA levels
  • Undetectable plasma HIV-1 RNA followed by sustained virologic rebound with persistently detectable plasma HIV-1 RNA
• DHHS guidelines define virologic failure as confirmed HIV-1 RNA > 200 copies/mL (Management Guidelines)[...

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