Reaching Undetectable Viral Loads After Initial HIV Treatment

An HIV patient’s chance for long-term treatment success is maximized when their first-line regimen produces an undetectable viral load. A persistently detectable viral load leads to the development of resistance and subsequent immunological and virological failure. It is important to select a regimen with excellent efficacy, tolerability and toxicity profile that is also easy to administer. Tenofovir/emtricitabine provides an effective and well-tolerated nucleoside analog reverse transcriptase inhibitor (NRTI) combination. Regimens with ritonavir-boosted protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors are superior to ritonavir-unboosted PIs and NRTIs in reducing viral load. Data suggest that regimens with lopinavir/ritonavir or efavirenz have the best long-term chance of producing an undetectable viral load.