Time for T

from The AIDS Reader

Graeme Moyle, MD, MBBS

The management of persons with virus resistant to multiple antiretroviral drug classes is a major challenge in clinical practice.

Studies of resistance testing indicate an advantage of both genotypic and phenotypic evaluations over “educated guesswork” (often in these trials called “standard of care”) in guiding drug choice in new regimens.

However, success in resistance-testing studies is also influenced by the availability of treatment options. For example, the recently published NARVAL study, which was performed predominantly in patients who had received multiple lines of antiretroviral therapy and commonly had virus resistant to all three approved drug classes, did not find the advantages of resistance-guided therapy that had been reported from the VIRADAPT, GART, VIRA3001, or Havana studies.

This underlines the need for new drug classes that will provide the backbone of new regimens for the successful long-term management of these persons with virus resistant to approved drug classes.

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