Initiating HIV/AIDS Therapy in Treatment-Naïve Patients How important is resistance when selecting HAART?
	Enlarged Version of Graphics Below	Dr. Kwakwa (OC): I think it's very important both for those of us who plan to sequence regimens, and for those of us who plan to keep the patient, whenever possible, on one regimen for years to come, and it's important in two ways. First, it is important to have an idea of what sort of resistance patterns will emerge should the patient's virus develop resistance to the medications that you may be giving them, and to see what to do further down the line beyond that particular regimen. It's also important for another reason, and I think this is becoming increasingly popular. Those regimens that have high barriers to resistance, where you may develop failure to the regimen without necessarily having resistance to as many resistance mutations to the medications as possible. This, of course, leaves many more options open should you choose to change therapy at that time, so in the sense of avoiding or delaying, or protecting against resistance, and also in the sense of sort of selecting, to some degree, a mutation pattern, if you will, should resistance occur. Dr. Wohlfeiler (OC): I think that the first consideration is to design what you think is going to be the best regimen for that patient in terms of adherence, side effects, and potency. The fact of the matter is that if you give a patient a regimen that's effective, that suppresses the virus, and that they can be adherent to because the dosing fits their life and there aren't side effects that are going to be problematic, then the reality is that you aren't going to have to worry that much about resistance developing. So I think that really becomes the most important thing. I think it's always important to have in the back of your mind an idea about where you're going to go next if this regimen fails. And so that always does figure into the equation. But it's not the most important factor.
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