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Guidelines from both the U.S. Department of Health and Human Services and the International AIDS Society–USA recommend that patients who are experiencing virologic failure have their regimens modified promptly to achieve virologic suppression. However, delaying a regimen change in these circumstances can be tempting because patients on failing treatments often feel fine and exhibit no immediate adverse immunologic effects.
To examine the consequences of delaying treatment changes, researchers used data from two prospective cohort studies. They identified 982 patients who experienced virologic failure between February 1996 and May 2006 while on their first potent combination antiretroviral regimens. The primary variable of interest was time u…