Therapeutic Drug Monitoring

Highly active antiretroviral therapy (HAART) can suppress viral replication and substantially prolong patient life. It can also fail for a number of reasons, including poor adherence, insufficient drug potency, emergence of resistance, cellular factors, and pharmacokinetic factors. Although many antiretroviral drugs are now available, a limited number of combinations has been proven effective for individual patients. With sequential treatment failures, the durability of virologic response tends to decrease with subsequent treatment regimens until the patient is left with few or no therapeutic options. There is evidence that many treatment-naïve patients will switch from their initial regimen within one year. It is imperative that we adopt strategies that will optimize the use of available therapies, so as to achieve long-term viral suppression.

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