What are the treatment endpoints in antiretroviral therapy of HIV infection?

Updated: Apr 18, 2019
  • Author: R Chris Rathbun, PharmD, BCPS (AQ-ID), AAHIVP; Chief Editor: John Bartlett, MD  more...
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Answer

Answer

Virologic suppression is the goal for all patients on antiretroviral therapy. Suppression is defined as an HIV-1 RNA level below the lower limit of detection of available assays. Different assays may have different lower limits of detection, generally ranging between 20 copies/mL and 75 copies/mL. For most patients, virologic suppression should be achieved 8 to 24 weeks after starting therapy. This may be prolonged in patients with very high baseline viral loads. The time to suppression may also vary based on the antiretroviral regimen selected. Historically, an interim measure of antiretroviral efficacy was a one log10 decline in HIV RNA by 2-8 weeks. If either of these endpoints is not met, the patient should be evaluated to determine whether nonadherence, drug intolerance, or resistance is a factor. Alteration of therapy may be necessary based on the specific circumstances. [8]


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