Managing HIV/AIDS Therapy in Treatment-Experienced Patients What about a patient with limited prior experience and multiple drug resistance?
	Enlarged Version of Graphics Below	Dr. Bellos (OC): In that particular setting, one has to weigh the options of looking at their remaining drugs that they show activity against, and then deciding in conjunction with the patient that this regimen may be more complicated to take. "It may contain more pills. You may have to take it twice a day. However, I suspect that we will be able to improve your T-cells and decrease your viral load, and thus prevent any of the long-term complications or infectious complications that we typically worry about." Dr. Wohlfeiler (OC): That becomes certainly more complicated. And I think that you really do have to rely on your resistance testing at that point to really accurately guide your therapeutic decisions. I think once you have multiple drug resistant mutations, resistance testing really becomes critical. Dr. Kwakwa (OC): There, you have to switch out either the entire regimen, or at least two of the drugs in the regimen, provided that there is resistance to only two of the drugs, and no cross-resistance to the third, and in all of these patients, it is very important to determine the cause, if possible, of the developmental resistance.
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