Management of Virologic Failure and HIV Drug Resistance

doi:10.1016/j.idc.2019.05.004

Review

. 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

Suzanne M McCluskey¹, Mark J Siedner², Vincent C Marconi³

Affiliations

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.

PMID: 31255384
PMCID: PMC6688946
DOI: 10.1016/j.idc.2019.05.004

Review

Management of Virologic Failure and HIV Drug Resistance

Suzanne M McCluskey et al. Infect Dis Clin North Am. 2019 Sep.

. 2019 Sep;33(3):707-742.

doi: 10.1016/j.idc.2019.05.004. Epub 2019 Jun 27.

Authors

Suzanne M McCluskey¹, Mark J Siedner², Vincent C Marconi³

Affiliations

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.

PMID: 31255384
PMCID: PMC6688946
DOI: 10.1016/j.idc.2019.05.004

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.

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References

1. Joint United Nations Programme on HIV/AIDS. 90-90-90: An ambitious treatment target to help end the AIDS epidemic. 2014.
1. Centers for Disease Control. HIV in the United States. https://www.cdc.gov/hiv/images/library/infographics/continuum-infographi.... Published 2018. Accessed December 7, 2018.
1. Bradley H, Hall HI, Wolitski RJ, et al. Vital Signs: HIV diagnosis, care, and treatment among persons living with HIV--United States, 2011. MMWR Morb Mortal Wkly Rep. 2014;63(47):1113–1117. - PMC - PubMed
1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV. United States Department of Health and Human Services; http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Accessed December 4, 2018.
1. Hermans LE, Moorhouse M, Carmona S, et al. Effect of HIV-1 low-level viraemia during antiretroviral therapy on treatment outcomes in WHO-guided South African treatment programmes: a multicentre cohort study. The Lancet Infectious diseases. 2018;18(2):188–197. - PubMed

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[1] Joint United Nations Programme on HIV/AIDS. 90-90-90: An ambitious treatment target to help end the AIDS epidemic. 2014.

[2] Joint United Nations Programme on HIV/AIDS. 90-90-90: An ambitious treatment target to help end the AIDS epidemic. 2014.

[3] Centers for Disease Control. HIV in the United States. https://www.cdc.gov/hiv/images/library/infographics/continuum-infographi.... Published 2018. Accessed December 7, 2018.

[4] Centers for Disease Control. HIV in the United States. https://www.cdc.gov/hiv/images/library/infographics/continuum-infographi.... Published 2018. Accessed December 7, 2018.

[5] Bradley H, Hall HI, Wolitski RJ, et al. Vital Signs: HIV diagnosis, care, and treatment among persons living with HIV--United States, 2011. MMWR Morb Mortal Wkly Rep. 2014;63(47):1113–1117. - PMC - PubMed

[6] Bradley H, Hall HI, Wolitski RJ, et al. Vital Signs: HIV diagnosis, care, and treatment among persons living with HIV--United States, 2011. MMWR Morb Mortal Wkly Rep. 2014;63(47):1113–1117. - PMC - PubMed

[7] Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV. United States Department of Health and Human Services; http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Accessed December 4, 2018.

[8] Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV. United States Department of Health and Human Services; http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Accessed December 4, 2018.

[9] Hermans LE, Moorhouse M, Carmona S, et al. Effect of HIV-1 low-level viraemia during antiretroviral therapy on treatment outcomes in WHO-guided South African treatment programmes: a multicentre cohort study. The Lancet Infectious diseases. 2018;18(2):188–197. - PubMed

[10] Hermans LE, Moorhouse M, Carmona S, et al. Effect of HIV-1 low-level viraemia during antiretroviral therapy on treatment outcomes in WHO-guided South African treatment programmes: a multicentre cohort study. The Lancet Infectious diseases. 2018;18(2):188–197. - PubMed

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Management of Virologic Failure and HIV Drug Resistance

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Management of Virologic Failure and HIV Drug Resistance

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