Practical aspects of human immunodeficiency virus multiresistance in modern clinical practice

Abstract

The article presents an analysis of a special clinical case: a male patient with perinatal HIV infection and the development of HIV multi-resistance to antiretroviral drugs. Multiple corrections of treatment regimens were carried out based on the results of determining HIV resistance to the antiretroviral drugs used. The treatment regimen included antiretroviral drugs with fundamentally new mechanisms of action for HIV, not registered in the Russian Federation. However, to date, in the patient with more than twenty years of experience in antiretroviral therapy, it has not been possible to achieve immunological and virological efficacy of treatment. There continues to be a persistent decrease in the indicators of the immune status and an increase in the viral load of HIV in the blood, the appearance of clinical symptoms of opportunistic diseases indicating the progression of HIV infection and an unfavorable vital prognosis, despite the use of various combinations of antiretroviral drugs. This observation demonstrates the difficulties in choosing an effective antiretroviral therapy, taking into account the established sensitivity of HIV to antiretroviral drugs and the possibility of their progredient administration. It is certainly necessary to analyze all ART regimens with the results of HIV resistance to antiretroviral drugs using to improve the effectiveness of therapy is in each case.