Expect NNRTI Resistance Even After Staggered Drug Discontinuation

Even when components of an NNRTI-based regimen were stopped in a staggered fashion, NNRTI resistance emerged in 20% of patients.

Interrupting NNRTI treatment can lead to drug resistance, in part because, after the regimen is stopped, the long half-life of efavirenz or nevirapine can translate into days or even weeks of what is effectively NNRTI monotherapy. Some experts advocate minimizing this effect by stopping NNRTIs several days before stopping the shorter-lived agents in a regimen. However, new data suggest that even this tactic does not help.

As part of an ACTG observational study examining the safety of treatment discontinuation in patients with high pretreatment CD4-cell counts, 54 patients stopped suppressive NNRTI-based antiretroviral therapy in a staggered fashion, stopping the NNRTI component first and then the NRTI and PI components 2 days later. Virologi…

Reviewing Author

Abigail Zuger, MD

Disclosures

Nothing to disclose

Abigail Zuger, MD

Disclosures

Nothing to disclose

Expect NNRTI Resistance Even After Staggered Drug Discontinuation

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Reviewing Author