Management of Virologic Failure and HIV Drug Resistance

Infect Dis Clin North Am. 2019 Sep;33(3):707-742. doi: 10.1016/j.idc.2019.05.004. Epub 2019 Jun 27.

Abstract

Approximately 20% of people with HIV in the United States prescribed antiretroviral therapy are not virally suppressed. Thus, optimal management of virologic failure has a critical role in the ability to improve viral suppression rates to improve long-term health outcomes for those infected and to achieve epidemic control. This article discusses the causes of virologic failure, the use of resistance testing to guide management after failure, interpretation and relevance of HIV drug resistance patterns, considerations for selection of second-line and salvage therapies, and management of virologic failure in special populations.

Keywords: Antiretroviral therapy; HIV drug resistance; HIV-1; Treatment failure; Virologic failure.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Retroviral Agents / pharmacology*
  • Anti-Retroviral Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active / methods*
  • Disease Management*
  • Drug Resistance, Viral*
  • HIV / drug effects*
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • Humans
  • Sustained Virologic Response
  • Treatment Failure
  • United States

Substances

  • Anti-Retroviral Agents