Cover

Guides Changing treatment and drug resistance

Introduction

This booklet includes information about changing treatment. The main focus is on treatment failure because of drug resistance. It includes information about drugs in development and other research.

This booklet will help explain:

  • Why your treatment failed.
  • Which tests you need and what the results mean.
  • Choices for your next combination.
  • How to help make sure your next treatment works.

Most people starting treatment in 2011 get their viral load to undetectable levels on their first treatment. If a treatment change is needed it is usually to reduce side effects.

However, about 10% of people change because their viral load does not become undetectable. This is usually because of prior drug resistance or problems with adherence.

In addition, some people have already developed resistance to more than one earlier combination.

This is still usually easy to treat because of the number of available drugs.

Less than 5% of HIV-positive people in the UK have developed resistance to all drugs. These people are waiting for new drugs to be developed.

Within this group of most treatment-experienced people, the options will also depend on current health and risk of becoming ill.

This booklet includes information on all these different situations.

Although most people have good options, each chance at a new treatment is too important to waste.

Even with over 25 meds from five families of drugs, cross-resistance can mean that you only get three or four good chances at treatment.

Each chance needs to be seen as life saving. This booklet should help you understand the best way to help your next treatment work.

Changes to this edition

This edition has been reorganised and rewritten throughout.

There are more graphics and many have been redrawn.

More emphasis is given to the need for support, including for adherence.

It includes the most recently approved drugs.

  • Etravirine (a new NNRTI) has been approved in Europe.

It also includes information about potential new drugs that are in development.

  • Rilpivirine (a new NNRTI) is close to being approved.
  • New compounds are in development from all major drug classes.

February 2011

Decisions relating to your treatment should always be taken in consultation with your doctor. Information in this guide is intended to support those discussions.

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