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

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

José R. Arribas, MD
Professor of Medicine
Department of Medicine
Autónoma University School of Medicine
Head, Infectious Diseases Unit
Department of Internal Medicine
Hospital La Paz
Madrid, Spain

Melissa Badowski, PharmD, MPH, FIDSA, FCCP, BCIDP, BCPS, AAHIVP
Clinical Associate Professor
Section of Infectious Diseases Pharmacotherapy 
Department of Pharmacy Practice
University of Illinois at Chicago, College of Pharmacy
Chicago, Illinois

Link to full program:
bit.ly/3Z44Gq3

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