Risk of Resistance with Nonnucleoside Reverse Transcriptase Inhibitors vs. Boosted Protease Inhibitors

What are the long-term risks for virologic failure and resistance in patients starting combination antiretroviral therapy (ART)? New data from the UK CHIC Study provide plausible estimates.

Patients were eligible for analysis if they started ART after December 1997 with a regimen that is recommended by current treatment guidelines — two nucleoside reverse transcriptase inhibitors (NRTIs) plus either a nonnucleoside reverse transcriptase inhibitor (NNRTI) or a boosted protease inhibitor (PI). Virologic failure was defined as having two consecutive viral-load measurements >400 copies/mL. Patients were considered to have resistant virus if, at the time of virologic failure, they had evidence of at least one mutation listed by the International …