Toxicity & side effects: switching therapy
- Modification of ART regimen in virologically suppressed patients
- Reduce or prevent toxicity
- Newer regimens are associated with fewer serious adverse effects. From 2011 to 2017, Swedish registry found that reporting of side effects decreased from 32% to 15%.
- PLWH initiating ART in trials report short-term adverse effects infrequently (< 10%).
- Improve long-term adherence by reducing pill burden and dosing frequency OR eliminating dietary requirements
- Avoid long-term ART toxicities, especially in setting of co-morbidities, such as cardiovascular, kidney, or metabolic disease
- Avoid drug interactions
- For example, in solid organ transplantation, drug-drug interactions occur between protease inhibitors (i.e., DRV) or pharmacokinetic boosters (i.e., cobi) and required immunosuppressive medications (i.e., tacrolimus).
- Exercise option of long-acting injectable ART
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