A virological perspective on resistance in highly treatment-experienced patients

An increased number of HIV-infected patients have experienced most or all available antiretroviral drugs. or these patients, building a salvage or rescue regimen is difficult. Resistance to highly active antiretroviral therapy (HAART) makes the clinical decision process complex. However, growing understanding of HIV dynamics and resistance patterns to HAART may help physicians make more rational decisions when planning treatments in highly experienced patients. Viral resistance mutations may have favourable effects in salvage treatment by reducing viral fitness and pathogenicity. Similarly, interactions between mutations may possibly increase susceptibility to other antiretroviral drugs.