Switch strategies in antiretroviral therapy regimens

Expert Rev Anti Infect Ther. 2014 Sep;12(9):1055-74. doi: 10.1586/14787210.2014.944506. Epub 2014 Jul 30.

Abstract

Despite great advances in antiretroviral therapy in the last decade, several limitations still remain such as adverse effects, lack of adherence and drug-drug interactions. Switching antiretroviral therapy in stable, virologically suppressed patients with the aim of improving tolerability and convenience is an expanding strategy in clinical practice. Several factors need to be taken into consideration when switching a suppressive regimen, such as previous virologic failure, genetic barrier of the new regimen, prior duration of virologic suppression and expected level of adherence. The most frequently used strategies include reductions in the number of pills, drugs or doses. Although switching strategies may be useful, not all the regimens used in clinical practice are based on data from randomized clinical trials and some may not be the best option for certain patients; therefore, therapy should be individualized taking into consideration available information as well as patient and drug characteristics.

Keywords: HIV; antiretroviral therapy; monotherapy; simplification; switch.

Publication types

  • Review

MeSH terms

  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / economics
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active
  • Clinical Trials as Topic
  • Cost Savings
  • Drug Administration Schedule
  • HIV / drug effects
  • HIV / enzymology
  • HIV / genetics
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • Humans
  • RNA, Viral / blood

Substances

  • Anti-HIV Agents
  • RNA, Viral