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