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

Management of Virologic Failure and HIV Drug Resistance.

Author information

1
Division of Infectious Diseases, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, GRJ5, Boston, MA 02114, USA. Electronic address: smccluskey@mgh.harvard.edu.
2
Division of Infectious Diseases, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, GRJ5, Boston, MA 02114, USA.
3
Division of Infectious Diseases, Department of Global Health, Emory University School of Medicine, Rollins School of Public Health, Health Sciences Research Building, 1760 Haygood Dr NE, Room W325, Atlanta, GA 30322, USA.

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

PMID:
31255384
PMCID:
PMC6688946
[Available on 2020-09-01]
DOI:
10.1016/j.idc.2019.05.004

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