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The term “treatment-experienced” is imprecise, encompassing both patients with extensive multidrug-resistant virus and those with relatively little drug exposure and limited resistance according to genotype testing. The TITAN study evaluates the efficacy and tolerability of darunavir-based therapy in the latter group — a treatment-experienced population with comparatively little viral resistance.
The trial (sponsored by the manufacturer of darunavir) involves 595 HIV-infected patients who, at study entry, were treatment-experienced, had viral loads >1000 copies/mL, and had never received lopinavir/ritonavir. Participants were randomized to receive darunavir (600 mg, plus 100 mg of ritonavir, twice daily) or standard doses of lopinavir/r (ini…