Modifying Antiretroviral Therapy in Virologically Suppressed HIV-Infected Patients

  • Author: José R. Arribas, MD (More Info)
  • Section Editor: Eric S. Daar, MD
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 3/17/20 (What's New)


  • Patients who are currently receiving a suppressive regimen of 2 NRTIs plus a PI and who harbor NRTI resistance mutations are at increased risk of virologic failure from switching to an NNRTI[Martínez 2003]
    • NNRTIs have a low genetic barrier to resistance and must be supported by an active background regimen rather than one that has been weakened by the presence of NRTI resistance
  • In the SPIRIT trial, switching from ritonavir-boosted PI–based regimens to single-tablet emtricitabine/rilpivirine/tenofovir DF was noninferior to continued boosted PI–based therapy in patients with no history of previous treatment failure[Palella 2014]

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