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| Managing Resistance to
HIV Therapy |
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The aim of antiretroviral therapy is to suppress
viral replication for as long as possible, to keep mutations to a minimum and so limit the
appearance of resistant variants. In practice, achieving a viral load below the level of
detection appears to be associated with a durable treatment response (Figure 1).
Figure 1: Time to failure predicted
by virological nadir
102 phase 2 RTV failures (>0.6log Virological load (VL) rise from nadir)
Kempf D, et al. HIV Drug Resistance Workshop, St Petersburg 1997: Abstract 62
| This figure clearly shows how the level of treatment
response achieved is related to the length of response to therapy. Individuals who have an
optimum response to therapy ie. viral load falls below 200 viral copies/ml, generally
demonstrate a longer treatment response than individuals who do not achieve such low viral
loads following treatment. The virological load
nadir is the point at which an individuals viral load is at its lowest, as
established by sequential viral load testing. |
Causes
of Treatment Failure
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