Brizzi Marisa B, Cable Tracy L, Patel Dimple C, Williams Kelli, Adjei Zoe, Fichtenbaum Carl J
HIV Clinical Pharmacy Specialist, Department of Pharmacy, University of Cincinnati Health, Cincinnati, OH, USA.
Assistant Professor of Medicine, Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
J Int Med Res. 2024 Dec;52(12):3000605241301883. doi: 10.1177/03000605241301883.
Antiretroviral (ARV) drug resistance poses a threat to ending the HIV epidemic. As the rates of integrase resistance continue to increase globally, the availability of options for HIV treatment becomes limited. Heavily treatment-experienced (HTE) people with HIV (PWH) are limited to two or fewer available fully active ARV classes and are more likely to have an AIDS-defining event. Appropriate identification and management of HTE PWH is crucial to improving patient outcomes and reducing the future spread of drug-resistant HIV. As treatment options become more limited owing to drug resistance, the availability of more potent drugs with a marked increase in virologic suppression is needed in the current ART era. The purpose of this narrative review is to review the identification of HTE PWH, novel mechanisms of resistance, and management of HTE PWH in resource-rich and resource-limited settings using novel ARVs and combination ART.
抗逆转录病毒（ARV）药物耐药性对终结艾滋病流行构成威胁。随着全球整合酶耐药率持续上升，用于治疗HIV的选择变得有限。有大量治疗经历（HTE）的HIV感染者（PWH）只能使用两种或更少的完全有效的抗逆转录病毒药物类别，并且更有可能发生艾滋病定义事件。对有大量治疗经历的HIV感染者进行适当识别和管理对于改善患者预后以及减少耐药HIV的未来传播至关重要。由于耐药性导致治疗选择变得更加有限，在当前抗逆转录病毒治疗时代，需要有更多能显著提高病毒学抑制效果的强效药物。本叙述性综述的目的是回顾在资源丰富和资源有限的环境中，如何识别有大量治疗经历的HIV感染者、新的耐药机制以及使用新型抗逆转录病毒药物和联合抗逆转录病毒治疗来管理有大量治疗经历的HIV感染者。
