CCO Infectious Disease Podcast

Managing ART Failure: Answering the Questions

Episode Summary

Hear from expert faculty as they discuss questions about managing ART failure including guideline definitions and recommendations, the likelihood of failure with resistance with first-line ART regimens, drug‒drug interaction considerations, and more.

Episode Notes

In this episode, Daniel R. Kuritzkes, MD, and Cristina Mussini, MD, discuss managing ART failure, including:

• The definitions of virologic blips, low-level viremia, and virologic failure on ART
• The infrequency of failure with resistance on first-line INSTI-based ART and the instances where this has occurred with BIC- and DTG-based ART in clinical trials and in the real world
• The potential reasons for ART failure, including patient/adherence-related factors, HIV-related factors, and regimen-related factors
• The impact of adherence on viral suppression with BIC- and DTG-based ART
• Drug-drug interactions as a reason for failure of first-line INSTI-based ART
• What to do if someone is experiencing virologic failure requiring an ART change
• The use of proviral DNA testing in patients with viral suppression or low-level viremia with ART treatment experience
• The impact of high HIV-1 RNA on ART effectiveness
• The impact of NRTI resistance, including the M184V and K65R mutations, on the effectiveness of BIC- and DTG-based ART
• Strategies to encourage and measure patient adherence to ART 

Presenters

Daniel R. Kuritzkes, MD
Harriet Ryan Albee Professor of Medicine
Harvard Medical School
Chief, Division of Infectious Diseases
Brigham and Women’s Hospital
Boston, Massachusetts

Cristina Mussini, MD
Professor
Department of Infectious Diseases
University of Modena and 
Reggio Emilia
Modena, Italy

Link to full program: https://bit.ly/3HPu4Lk