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For HIV-infected patients in resource-limited settings, the WHO recommends using easily administered first-line antiretroviral therapy (ART): a non-nucleoside reverse transcriptase inhibitor (NNRTI) plus two nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs). For patients who require second-line ART, the WHO recommends ritonavir-boosted lopinavir plus two or three NRTIs.
In an open-label trial spanning 37 sites on five continents, researchers randomized 541 HIV-infected adults with confirmed virologic failure after ≥24 weeks on first-line ART to receive either the WHO's recommended second-line regimen (control group) or boosted lopinavir plus raltegravir, an integrase inhibitor. Sites with access to resistance testing had to u…