Strategies for rescue therapy

Human immunodeficiency virus (HIV) RNA load will be detectable in approximately 40% of non-naive HIV patients who are taking triple therapy after 1 year of follow-up. Treatment failure may involve factors related to the physician (poor prescribing), the patient (poor compliance due to complicated regimens or side-effects), or the drug (pharmacological aspects such as poor bioavailability). The primary mechanism for drug failure is viral resistance to available HIV therapies. Whereas initial therapy should be aggressive, second- or third-line therapy demands a more measured approach, as treatment options become more limited. Rescue or salvage therapy refers to therapy after everything else has failed. Issues related to rescue therapy for HIV-positive subjects include drug holidays, drug recycling and the potential for new drugs in this setting