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174 Salvage Therapy in HIV-1 Infected Patients

Castagna, Antonella

JAIDS Journal of Acquired Immune Deficiency Syndromes: April 2011 - Volume 56 - Issue - p 72
doi: 10.1097/01.qai.0000397357.45921.20
Abstracts
Free

Department of Infectious Disease, San Raffaele Scientific Institute, Via stamira d'Ancona 20, Milan, Italy

Resistance of HIV-1 to antiretrovirals is an issue of clinical relevance even with the availability of five antiretroviral classes. Prevalence of failure to the three original antiretroviral classes is estimated to range from 2.1% to 16% after HAART initiation and it increases over time from treatment baseline.

International guidelines recommend the use of at least two active drugs in constructing a new antiretroviral regimen to obtain virologic success and adding a compound with a different mechanism of action often increases the chances of virologic response. With the introduction of new drug classes and new-generation compounds of older classes in the antiretrovirals armamentarium, the chances of achieving virologic success in patients with resistance to all three original antiretroviral classes are certainly higher than in the past. Patients who experience virologic failure and show resistance to new antiretrovirals are, however, described both in randomized trials and clinical settings. That is why in certain settings patients do not have two fully active drugs, especially in the presence of prior exposure to several suboptimal therapies. In this talk I will review several strategies that might be an effective option to obtain virologic success in patients with triple class resistance as well as treatment strategies for patients who do not have two active drugs to construct a new effective antiretroviral regimen with, after virologic failure.

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