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: 10/12/18 (What's New)

Summary

Introduction

  • In recent clinical trials of antiretroviral-naive patients, the proportion of patients achieving undetectable HIV-1 RNA was approximately 90%
  • For some patients there are often important, nonvirologic reasons to modify their antiretroviral regimen, such as drug intolerance or the need to simplify the regimen

Reasons for Modifying Antiretroviral Therapy

  • Potential reasons for considering a modification to the antiretroviral regimen of a virologically suppressed patient include tolerability and toxicity (Table 1)[Elzi 2010] and/or to preserve treatment options, avoid or manage drug–drug or drug–food interactions, or decrease cost (Table 2)
  • The DHHS antiretroviral therapy guidelines panel outlines specific criteria for patients on suppressive antiretroviral therapy to be considered for treatment modification (Management Guidelines)[DHHS ART]