Optimizing ART With HIV Resistance: Drs Arribas and Badowski
Answering the Questions on Optimizing Antiretroviral Therapy in Heavily Treatment–Experienced People With HIV: José R. Arribas and Melissa Badowski

Released: March 22, 2023

José R. Arribas
José R. Arribas, MD
Melissa Badowski
Melissa Badowski, PharmD, MPH, FIDSA, FCCP, BCIDP, BCPS, AAHIVP

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In this episode, José R. Arribas, MD, and Melissa Badowski, PharmD, MPH, FIDSA, FCCP, BCIDP, BCPS, AAHIVP, discuss optimizing antiretroviral therapy (ART) for people with HIV who are treatment experienced or failing a current ART regimen, including:

  • The use of proviral DNA genotyping for switching therapy
  • Maintaining nucleos(t)ide reverse-transcriptase inhibitors after a first failure
  • The role of zidovudine in salvage regimens
  • The use of twice-daily darunavir with protease inhibitor resistance and twice-daily dolutegravir with integrase strand transfer inhibitor resistance
  • Simplification of regimens and long-acting therapies for people with HIV who are highly treatment experienced
  • Drug‒drug interactions that may warrant dosing changes to avoid resistance development
  • When to consider antiretrovirals with novel mechanisms of action, such as fostemsavir, ibalizumab, and lenacapavir
  • The logistics of dosing, administration, and development of a complete ART regimen that includes novel mechanism antiretrovirals
  • Addressing psychosocial factors to increase the chance of success on a new ART regimen
  • Drug‒drug interactions with novel mechanism agents
  • How common ART resistance is for people with HIV in their own practices
  • The possibility of using long-acting cabotegravir plus rilpivirine in people with viremia in the future
  • Addressing low-level viremia