This booklet, updated in February 2013, about changing HIV treatment and drug resistance explains when and why treatment needs to be changed, which tests are used and what the results mean, how to choose drugs for the next combination and how to help make sure the next treatment will work well.
It also includes information about new drugs in development and other research.
Open publication as an online magazine.
Introduction
Changing treatment and drug resistance
- Reasons to change treatment
- What is second-line treatment?
- How long should I use my first combination?
- How can drugs ‘fail’ and I feel fine?
- What is HIV drug resistance?
Resistance and adherence
What to do if viral load rebounds
Important monitoring tests
- Viral load tests
- Resistance tests
- How to interpret resistance tests
- TDM (Therapeutic Drug Monitoring)
- IQ and VIQ
- Viral tropism
- Getting the tests in the UK
Why a combination can fail
Deciding on your next combination
- How to find out about the strongest combination?
- How to choose new drugs
- After first treatment failure
- After multiple treatment failure
- Using up options
- When to use new drugs and when to wait?
Other treatment strategies
- Intensify treatment
- Using T-20
- Using five or more drugs
- Treatment interruptions
- Drug recycling using viral fitness
- Drugs in development
- Benefit of staying on treatment (using drugs that are still active)
Changing treatment to avoid side effects
Expanded access and pipeline drugs
Non ARV drugs
Record your treatment
Further information
Glossary
Credits and disclaimer
Tables and diagrams
References
This guide was written and compiled by Simon Collins for HIV i-Base. Thanks to the advisory group of HIV-positive people and healthcare professionals for comments and to Monument Trust for funding this publication.
1 February 2013