Section 3: Choosing a class
Factors to consider: treatment complexity
- Matthias has an extremely busy lifestyle
- Travels a lot with work
- Spends much of his time entertaining
- Has a busy social life, describing himself as a “party animal”
- How may his lifestyle affect this treatment regimen?
Factors to consider: resistance withfirst-generation NNRTIs
- Major disadvantages
- single mutation can confer resistance1
- broad class-wide cross-resistance2
- prevalence of NNRTI-resistant viral strains in treatment-naïve patients1–4
- Patients virologically failing an initial NNRTI regimen
- lose utility of all approved NNRTIs
- more likely to develop resistance than with PI-based regimen5
- may transmit resistant virus to others2
- Other fully active ARVs needed to protect from development of resistance
1. Weinstock HS, et al. J Infect Dis 2004;189:2174-80.
2. Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents, 2006: http://AIDSinfo.nih.gov.
3. Wensing AM, et al. J Infect Dis 2005;192:958-66.
4. Novak RM, et al. Clin Infect Dis 2005;40:468-74.
5. Von Wyl V, et al. Arch Intern Med 2007;167:1782-90.
Factors to consider: genetic barrierto the development of resistance
1. Antinori A, et al. AIDS Res Hum Retroviruses 2002;18:835-8.
2. Lecossier D, et al. J Acquir Immune Defic Syndr 2005;38:37-42.
3. Vingerhoets J, et al. IV EHDRW, 2006.
4. Bertoli A, et al. IV EHDRW, 2006.
5. de Mendoza C, et al. HIV Clin Trials 2006;7:163-71.