April 2009
This is a very exciting and hopeful time for people with HIV drug resistance. This is because it is the first time in many years that several new drugs became available at the same time. The goal of treatment for treatment experienced patients is now to get viral load reduced to less than 50 copies/mL.
Summary
Introduction
Resistance, cross-resistance and adherence
What, why, how…
- What is MDR treatment?
- Why change treatment?
- How can drugs ‘fail’ and I feel fine?
- Why viral load tests are important
What to do about a rising viral load
- Spikes and blips
- Test sensitivity
- When should I change?
- How do I choose the strongest combination?
- Importance of using new drug in combination with other sensitive drugs
Why a combination can fail
Important monitoring tests
- Viral load tests
- Resistance tests
- How to interpret resistance tests
- TDM tests (therapeutic drug monitoring)
- Inhibitory quotient and viral tropism test
- Getting the tests in the UK
Choices for your next combination
Other treatment strategies
- Intensify treatment
- Using T-20
- Using five or more drugs
- Treatment interruptions
- Drug boosting and recycling
- Using drugs in development
- Using viral fitness
- Benefits of staying on treatment