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Updated: Jun 23, 2026

Quadruple-Checkerboard: A Modification of the Three-Dimensional Checkerboard for Studying Drug Combinations
Published on: July 24, 2021
Combining protease inhibitors with new drug classes in treatment-experienced patients
1Department of Medicine, University of Toronto, University Health Network, Immunodeficiency Clinic, Toronto, Ontario M5G2C4, Canada. Sharon.walmsley@uhn.on.ca
Purpose Of Review:
The availability of new drugs in existing classes and new drugs in new classes has enabled better management of the treatment-experienced patient. This review will highlight the advances in the field and the new goals of therapy for this patient population.
Recent Findings:
The treatment-experienced patient on a failing regimen should receive a new combination of at least two, and ideally three, new agents that includes a drug within a new class. The goal of therapy is suppression of viral replication to less than 50 copies/ml. The new protease inhibitors with activity against strains with resistance to earlier members of the class are an important backbone to the new therapy given their high barrier to resistance.
Summary:
The treatment-experienced patient can now be successfully managed with new agents and new classes of antiviral agents.
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