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HIV Drug Resistance

Detection and management of antiretroviral resistance

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is HIV Drug Resistance?

HIV drug resistance occurs when viral mutations decrease the susceptibility of HIV to antiretroviral drugs, leading to virologic failure, persistent viremia, and disease progression if not addressed promptly.

Genotypic resistance assays sequence reverse transcriptase, protease, and integrase regions to detect mutations such as M184V, K65R, K103N, Y181C, and R263K, which inform regimen switches.

Treatment requires constructing a regimen with at least two and preferably three fully active drugs, often integrating second-generation INSTIs (dolutegravir, bictegravir), boosted PIs, or novel agents like fostemsavir and lenacapavir.

Symptoms

Persistent detectable viral load on therapy
Rebound viremia after suppression
Declining CD4 count
New opportunistic infections
Treatment fatigue and intolerance

Risk Factors

Suboptimal adherence
Drug-drug interactions
Use of single low-genetic-barrier agents
Pretreatment NNRTI resistance
Transmitted resistance

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Viral load above 200 copies/mL on therapy
  • Symptoms of opportunistic infection
  • Worsening immune status
  • Severe drug toxicity
  • Pregnancy planning while on therapy

Treatment Methods

01
Genotypic and phenotypic resistance testing
02
Adherence assessment and counseling
03
Switch to high-genetic-barrier regimen
04
Use of second-generation INSTIs
05
Therapeutic drug monitoring
06
Multidisciplinary HIV team review

Which Department to Visit?

You can visit our Enfeksiyon Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Enfeksiyon Hastalıkları Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.