Strategies for third line HIV therapy

May 2008     View PDF     En español

Most people living with HIV will face making decisions about treating their HIV disease at some point. Over time, some will change their regimens for various reasons, and likely change them several times. This can lead to being in a position where there are few options for adding new HIV drugs when it’s necessary.

Having extensive experience with various regimens is one reason you may face choosing third line therapy. Another reason could be that your HIV has become resistant to at least one drug in each of the three major classes: protease inhibit­ors, NRTIs and NNRTIs. A third reason includes treatment failure on at least two other regimens. The specific reasons why you switched from specific medicines determine if or how these drugs might be used again in another regimen.

Sometimes, people refer to third line therapy as salvage or rescue therapy. True or “deep” salvage therapy is when a person literally has no treatment options with resistance and/or intolerance to virtually all HIV drugs. Most people with some treatment failure do not need true salvage therapy. It’s often possible to create a viable, if not ideal, regimen for people even if you believe you’ve run out of options.

This publication sheds light on issues to consider when you’re confronted with making decisions for third line therapy. It also helps guide people who face true salvage therapy.