Department of Microbiology, Virology Laboratory, School of Biological Sciences, Faculty of Natural and Agricultural Sciences, North West University, Mafikeng, Private Bag, Mmabatho X2046, South Africa.
Viruses. 2023 Aug 13;15(8):1732. doi: 10.3390/v15081732.
Antiretroviral therapies (ARTs) have revolutionized the management of human immunodeficiency virus (HIV) infection, significantly improved patient outcomes, and reduced the mortality rate and incidence of acquired immunodeficiency syndrome (AIDS). However, despite the remarkable efficacy of ART, virologic failure remains a challenge in the long-term management of HIV-infected individuals. Virologic failure refers to the persistent detectable viral load in patients receiving ART, indicating an incomplete suppression of HIV replication. It can occur due to various factors, including poor medication adherence, drug resistance, suboptimal drug concentrations, drug interactions, and viral factors such as the emergence of drug-resistant strains. In recent years, extensive efforts have been made to understand and address virologic failure in order to optimize treatment outcomes. Strategies to prevent and manage virologic failure include improving treatment adherence through patient education, counselling, and supportive interventions. In addition, the regular monitoring of viral load and resistance testing enables the early detection of treatment failure and facilitates timely adjustments in ART regimens. Thus, the development of novel antiretroviral agents with improved potency, tolerability, and resistance profiles offers new options for patients experiencing virologic failure. However, new treatment options would also face virologic failure if not managed appropriately. A solution to virologic failure requires a comprehensive approach that combines individualized patient care, robust monitoring, and access to a range of antiretroviral drugs.
抗逆转录病毒疗法 (ART) 彻底改变了人类免疫缺陷病毒 (HIV) 感染的管理方式，显著改善了患者的预后，并降低了死亡率和获得性免疫缺陷综合征 (AIDS) 的发病率。然而，尽管 ART 的疗效显著，但病毒学失败仍然是 HIV 感染者长期管理中的一个挑战。病毒学失败是指接受 ART 的患者持续检测到可检测的病毒载量，表明 HIV 复制未得到完全抑制。它可能由于多种因素引起，包括药物依从性差、耐药性、药物浓度不理想、药物相互作用以及病毒因素，如耐药株的出现。近年来，人们做出了广泛的努力来理解和应对病毒学失败，以优化治疗结果。预防和管理病毒学失败的策略包括通过患者教育、咨询和支持性干预来提高治疗依从性。此外，定期监测病毒载量和耐药性测试可以早期发现治疗失败，并有助于及时调整 ART 方案。因此，具有更高疗效、更好耐受性和耐药性特征的新型抗逆转录病毒药物的开发为病毒学失败的患者提供了新的选择。然而，如果管理不当，新的治疗选择也可能会面临病毒学失败。解决病毒学失败需要综合的方法，结合个体化的患者护理、强有力的监测以及获得一系列抗逆转录病毒药物。
