HIV: how to manage heavily treatment-experienced patients

Article Details

Authors
Stephanie Spivack, Stephen Pagkalinawan, Rafik Samuel, David E Koren

Article Type
Review

DOI
10.7573/dic.2021-9-1

Related Articles

Article Page

Abstract

Although decreasing in prevalence, heavily treatment-experienced (HTE) persons with limited options for HIV treatment present unique complexities, even amongst experienced providers, as there is no single approach to successful management. HTE patients are described as those having two or less antiretroviral (ARV) classes available for use with limited fully active ARV agents within each class. A detailed understanding of the underlying processes that caused previous treatment failures, diagnostics to define resistance, resistance mechanisms and ARV pharmacology should all function in tandem to determine the next steps of clinical care. This narrative review provides an overview of the clinician approach to care, including diagnostics, approaches to regimen creation, relevant resources, and a broad array of both currently available and upcoming ARVs that may be used in regimens for HTE patients.

Keywords: antiretroviral therapy, HIV, HIV resistance, treatment experienced.

Citation: Spivack S, Pagkalinawan S, Samuel R, Koren DE. HIV: how to manage heavily treatment-experienced patients. Drugs Context. 2022;11:2021-9-1. https://doi.org/10.7573/dic.2021-9-1

Contributions: All authors contributed equally to the preparation of this manuscript. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: DEK has participated on advisory panels for Gilead, Janssen, Thera and ViiV and served as an independent consultant for Abbvie and Thera. The remaining authors report no conflicts of interest. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2021/12/dic.2021-9-1-COI.pdf

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2022 Spivack S, Pagkalinawan S, Samuel R, Koren DE. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2022 Spivack S, Pagkalinawan S, Samuel R, Koren DE. https://doi.org/10.7573/dic.2021-9-1. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/hiv-how-to-manage-heavily-treatment-experienced-patients

Correspondence: David E Koren, Temple University Hospital, Department of Pharmacy Services, 3401 North Broad Street, Philadelphia, PA 19140, USA. Email: david.koren2@tuhs.temple.edu

Provenance: Invited; externally peer reviewed.

Submitted: 2 September 2021; Accepted: 10 December 2021; Publication date: 1 March 2022.

Drugs in Context is published by BioExcel Publishing Ltd. Registered office: Plaza Building, Lee High Road, London, England, SE13 5PT.

BioExcel Publishing Limited is registered in England Number 10038393. VAT GB 252 7720 07.

For all manuscript and submissions enquiries, contact the Editorial office editorial@drugsincontext.com

For all permissions, rights and reprints, contact David Hughes david.hughes@bioexcelpublishing.com

Download free full text PDF