Management of Treatment-Experienced Patients With HIV

  • Author: Eric S. Daar, MD (More Info)
  • Section Editor: Eric S. Daar, MD
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 7/13/21 (What's New)

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

    Action required