Drug susceptibility in HIV infection after viral rebound in patients receiving indinavir-containing regimens.

Abstract

Complete and prolonged suppression of human immunodeficiency virus (HIV) replication is a primary objective of antiretroviral therapy.¹ Rates of viral suppression achieved by potent combination therapies exceed 90% in select clinical trial groups, but these rates are less with the same regimens outside research settings.^2-4 Rebound of plasma viremia also may occur after having suppression below level of detectability. Major factors contributing to loss of suppression include suboptimal drug potency, inadequate drug exposure, and insufficient regimen adherence. A large increase in CD4 cells with therapy, providing more target cells for virus replication, has been proposed⁵ and observed⁶ to contribute to loss of suppression.