Management of Treatment-Experienced Patients With HIV
Summary
- Most common results of resistance testing in patients experiencing treatment failure of first-line regimens report either no significant resistance or resistance to lamivudine or emtricitabine with or without NNRTI[Gallant 2006; Riddler 2008] or INSTI resistance,[Rockstroh 2013; Clumeck 2014; Wohl 2014] depending upon which regimen is used
- First-line therapy with ritonavir- or cobicistat-boosted PIs or dolutegravir or bictegravir with NRTIs is unlikely to select for PI or INSTI resistance[Gallant 2015; Clotet 2014; Walmsley 2013; Daar 2011; Sax 2017; Gallant 2017] First-line NNRTI Failure
- Patients experiencing NNRTI failure often have resistance to the NNRTI; DHHS recommended switch options include:
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