This booklet about changing HIV treatment and drug resistance was completely revised in February 2015.
It explains when and why treatment needs to be changed, which tests
are used and what the results mean, how to choose drugs for the next
combination and how to help make sure the next treatment will work well.
It also includes information about new drugs in development and other research.
All links open in a new window.
Summary
Introduction
Reasons to change treatment
- If your viral load never became undetectable…
- What to do if your viral load rebounds
- Viral load blips
- Confirmed viral rebound
- How can drugs “fail” when I feel fine?
Do some drugs develop resistance more easily?
Reasons a combination can fail
Why adherence is linked to drug resistance
Important monitoring tests
- Viral load tests
- Resistance tests
- How to interpret resistance tests
- TDM (Therapeutic Drug Monitoring)
- IQ and VIQ
- Viral tropism
- Getting the tests in the UK
When should I change and which drugs can I use?
How do I choose new drugs?
- General ideas or principles
- Cross-resistance by drug class
- When to use new drugs and when to wait?
- Pipeline drugs
- Expanded access drugs
- Non-ARV drugs
Other treatment strategies
- Intensify treatment
- Using T-20
- Using five or more drugs
- Treatment interruptions
- Drug recycling using viral fitness
- Benefit of staying on treatment using drugs that are still active
Changing treatment to avoid side effects
CD4 and viral load results
ARV treatment history
Further information
Feedback
Glossary
Credits
Tables and diagrams
References
This guide was written and compiled by Simon Collins for HIV i-Base. Thanks to the advisory group of HIV positive people and healthcare professionals for comments and to Monument Trust for funding this publication.About our guides
Information about how we produced this guide and the importance of using language that is direct and easy to understand.This includes information on how to write non technical medical information that may be useful as a resource for other organisations.
1 February 2015
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