Changing antiretroviral therapy for HIV infection

Antiretroviral therapy should only be changed by a clinician with experience in HIV management.

Once viral suppression is achieved, some patients who start on a 3-drug regimen can change to a 2-drug maintenance regimen – seek expert adviceLlibre, 2018Perez-Molina, 2017Pulido, 2017.

For patients with a fully suppressed viral load who cannot tolerate the initial treatment regimen, it may be possible to change a single drug in the regimen, provided resistance to the new drug was not detected on baseline testing.

For patients without a sustained viral load of less than 200 copies/mL (‘virological failure’), perform resistance testing while the patient is still taking the failing regimen. Seek expert advice on selection of a new antiretroviral regimen.