Treatment strategies for highly treatment-experienced HIV-infected patients

Abstract

The management of highly treatment-experienced HIV-infected patients is often complicated by baseline antiretroviral drug resistance, patient intolerabilities, drug–drug interactions and quality-of-life issues; which are all factors that can limit the ability to construct a potent regimen. The mainstay of treatment has been to use new agents with activity against resistant virus. New agents, such as enfuvirtide and tipranavir/ritonavir, have shown promising results in highly active antiretroviral treatment regimens among patients with extensive treatment histories and resistance profiles, especially when used in combination with other active agents. Other strategies include mega-highly active antiretroviral treatment, double-boosted protease inhibitors, structured treatment interruptions and maintaining a replicative compromised virus. The future development of newer agents with activity against resistant virus is desperately needed, and many new compounds and classes of antiretrovirals are currently being investigated.

Keywords::

• antiretroviral
• HIV
• protease inhibitor
• resistance
• tipranavir