SELECTION OF AN ANTIRETROVIRAL REGIMEN BASED ON THE RESISTANCE DATA

Abstract

As part of the global strategy against HIV, UNAIDS formulated the 90-90--90 targets. The targets mean that 90% of people living with HIV and receiving treatment should have achieved viral suppression. One of the main obstacles to achieving the goal is HIV resistance to antiretroviral therapy. It occurs when the virus mutates and affinity of active ingredients of drugs for the corresponding viral proteins is reduced. Drugs differ by the genetic barrier. Non-nucleoside reverse-transcriptase inhibitors lose their ability to inhibit the replication after a single mutation, and ritonavir- boosted protease inhibitors - after 5--8th mutation. The key factor for adequate viral suppression and reduction of risks is good adherence to treatment. Medication non-adherence creates a favorable environment in the body for the evolution of the virus. In the Russian Federation, the prevalence of primary resistance reaches 6.02%, and poor adherence equals 26%. The data and the results of examinations for mutations should be considered when selecting an antiretroviral regimen and approach to patient to improve adherence.

Keywords

• antiretroviral therapy
• viral suppression
• drug resistance to hiv
• 90–90–90 target
• adherence to therapy