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New Microbiol ; 47(1): 116-122, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38700893

RESUMEN

Management of virological failure in heavily treatment-experienced people with multidrug-resistant (MDR) HIV infection is a serious clinical challenge. New drugs with novel mechanisms of action have recently been approved, and their use has improved the outcome of subjects with limited treatment options (LTO). In this setting, the choice of antiretroviral therapy (ART) should be tailored based on the pattern of resistance, treatment history and patients' individual characteristics. While genotypic resistance testing is the reference method for analysing residual drug susceptibility, phenotypic resistance testing can provide additional support when facing LTO. Herein, we present the case of a patient with MDR HIV-1 infection on virological failure enrolled in the PRESTIGIO Registry. The salvage ART regimen, which included drugs with novel mechanisms of action (MoA), was tailored to the patient's clinical characteristics and on the resistance pattern explored with genotypic and phenotypic investigation, allowing the achievement of viro-immunological success. The use of recently approved drugs with novel MoA, combined with an optimized background regimen, may also achieve virological suppression in people with LTO.


Asunto(s)
Fármacos Anti-VIH , Cobicistat , Farmacorresistencia Viral Múltiple , Genotipo , Infecciones por VIH , VIH-1 , Compuestos Heterocíclicos con 3 Anillos , Piperazinas , Humanos , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/virología , Masculino , VIH-1/efectos de los fármacos , VIH-1/genética , Persona de Mediana Edad , Fármacos Anti-VIH/uso terapéutico , Fármacos Anti-VIH/farmacología , Compuestos Heterocíclicos con 3 Anillos/uso terapéutico , Compuestos Heterocíclicos con 3 Anillos/administración & dosificación , Farmacorresistencia Viral Múltiple/genética , Piperazinas/uso terapéutico , Cobicistat/uso terapéutico , Cobicistat/administración & dosificación , Sulfato de Atazanavir/uso terapéutico , Rilpivirina/uso terapéutico , Piridonas/uso terapéutico , Oxazinas/uso terapéutico , Pruebas de Sensibilidad Microbiana , Fenotipo
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