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Related Experiment Videos

Minimizing resistance consequences after virologic failure on initial combination therapy: a systematic overview.

John A Bartlett1, Jeffrey J Buda, Birgitta von Scheele

  • 1AIDS Research and Treatment Center, Duke University Medical Center, Durham, NC, USA. bartl004@mc.duke.edu

Journal of Acquired Immune Deficiency Syndromes (1999)
|March 17, 2006
PubMed
Summary

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For individuals starting HIV treatment, nonnucleoside reverse transcriptase inhibitor (NNRTI) and boosted protease inhibitor (PI) regimens show high virologic success rates. Boosted PI regimens better preserve future treatment options after failure.

Area of Science:

  • Infectious Diseases
  • Virology
  • Pharmacology

Background:

  • Antiretroviral therapy (ART) is crucial for managing HIV infection.
  • Selecting optimal first-line ART is essential for achieving viral suppression and long-term health.
  • Treatment-naive individuals require regimens that balance efficacy with the preservation of future therapeutic options.

Purpose of the Study:

  • To determine the best initial ART regimens for HIV-infected individuals.
  • To evaluate regimens based on virologic success (VS) rates.
  • To assess the impact of first-line ART failure on subsequent treatment choices.

Main Methods:

  • A systematic review of clinical trials involving combination ART in treatment-naive subjects.
  • Analysis of genotypic resistance mutations in patients experiencing virologic failure.

Related Experiment Videos

  • Calculation of regimen resistance cost (RCreg) and active drug (AD) scores using International AIDS Society-USA guidelines.

    • Main Results:

    • Nonnucleoside reverse transcriptase inhibitor (NNRTI) regimens achieved VS rates of 51%-76%.
    • Boosted protease inhibitor (PI) regimens demonstrated VS rates of 55%-79%.
    • Failures on boosted PI regimens had lower resistance costs and higher numbers of active drugs remaining compared to NNRTI failures.

    Conclusions:

    • NNRTI and boosted PI regimens are effective first-line options for HIV treatment.
    • Boosted PI regimens offer superior preservation of future treatment options following virologic failure compared to NNRTIs.