When should I change and which drugs can I use?

If viral rebound is confirmed, changing ART will reduce more resistance.

With some drug classes, switching early might mean you can still use other drugs in the class. This is especially important for NNRTIs, integrase inhibitors and T-20.

Each situation will be different. The timing for when you change will depend on how high viral load has rebounded.

It will also depend on the reasons for the rebound.

Some people change treatment if their viral load stays consistently detectable above 50 copies/mL.

Other people wait until viral load is confirmed above 200 or 500 copies/mL in case this is still a blip.

A resistance test can help decide.

Your treatment history is important when choosing your next ART.

• Usually you will have to change all your drugs.
• Sometimes you can just change one or two drugs.
• Sometimes you can just add one drug to intensify treatment. This is not generally recommended.

Last updated: 1 August 2021.