Antiretroviral therapy in treatment-experienced patients

William A O’Brien, MD, MS

Buried amongst the political hoopla and high profile of the XIV International AIDS Conference in Barcelona was a substantial amount of new information relevant for clinicians who manage patients with HIV infection.

Additional reassurance was provided to show that switching patients to more tolerable regimens is an acceptable and, in fact, desirable option, with little risk for patients who meet certain criteria regarding their treatment history and stage of disease. Conference attendees saw the first formal presentation of phase three clinical trials of the first fusion inhibitor, T-20, which exceeded the expectations of investigators who planned the study.

Additional support was given to HIV drug resistance testing in treatment-experienced patients, although the expectations for benefit are now more modest than initially thought. Finally, and most encouraging, the pipeline for new drugs – both those targeting reverse transcriptase and protease, as well as those exploiting novel targets – seems to be robust, and it is likely that new drugs that will help treatment-experienced patients are indeed on the horizon and will become more widely available during the next three years.

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