Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future

In the early years of the highly active antiretroviral therapy (HAART) era, HIV with resistance to two or more agents in different antiretroviral classes posed a significant clinical challenge. Multidrug-resistant (MDR) HIV was an important cause of treatment failure, morbidity, and mortality. Treat...

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Main Authors: Marianne Harris, Bohdan Nosyk, Richard Harrigan, Viviane Dias Lima, Calvin Cohen, Julio Montaner
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:AIDS Research and Treatment
Online Access:http://dx.doi.org/10.1155/2012/595762
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author Marianne Harris
Bohdan Nosyk
Richard Harrigan
Viviane Dias Lima
Calvin Cohen
Julio Montaner
author_facet Marianne Harris
Bohdan Nosyk
Richard Harrigan
Viviane Dias Lima
Calvin Cohen
Julio Montaner
author_sort Marianne Harris
collection DOAJ
description In the early years of the highly active antiretroviral therapy (HAART) era, HIV with resistance to two or more agents in different antiretroviral classes posed a significant clinical challenge. Multidrug-resistant (MDR) HIV was an important cause of treatment failure, morbidity, and mortality. Treatment options at the time were limited; multiple drug regimens with or without enfuvirtide were used with some success but proved to be difficult to sustain for reasons of tolerability, toxicity, and cost. Starting in 2006, data began to emerge supporting the use of new drugs from the original antiretroviral classes (tipranavir, darunavir, and etravirine) and drugs from new classes (raltegravir and maraviroc) for the treatment of MDR HIV. Their availability has enabled patients with MDR HIV to achieve full and durable viral suppression with more compact and cost-effective regimens including at least two and often three fully active agents. The emergence of drug-resistant HIV is expected to continue to become less frequent in the future, driven by improvements in the convenience, tolerability, efficacy, and durability of first-line HAART regimens. To continue this trend, the optimal rollout of HAART in both rich and resource-limited settings will require careful planning and strategic use of antiretroviral drugs and monitoring technologies.
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spelling doaj-art-2ae0be43757f4dc49a162f730b8509842025-08-20T03:54:43ZengWileyAIDS Research and Treatment2090-12402090-12592012-01-01201210.1155/2012/595762595762Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and FutureMarianne Harris0Bohdan Nosyk1Richard Harrigan2Viviane Dias Lima3Calvin Cohen4Julio Montaner5AIDS Research Program, Providence Health Care Institute, B518 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, CanadaCommunity Research Initiative of New England, Boston, MA 02111, USABritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, CanadaIn the early years of the highly active antiretroviral therapy (HAART) era, HIV with resistance to two or more agents in different antiretroviral classes posed a significant clinical challenge. Multidrug-resistant (MDR) HIV was an important cause of treatment failure, morbidity, and mortality. Treatment options at the time were limited; multiple drug regimens with or without enfuvirtide were used with some success but proved to be difficult to sustain for reasons of tolerability, toxicity, and cost. Starting in 2006, data began to emerge supporting the use of new drugs from the original antiretroviral classes (tipranavir, darunavir, and etravirine) and drugs from new classes (raltegravir and maraviroc) for the treatment of MDR HIV. Their availability has enabled patients with MDR HIV to achieve full and durable viral suppression with more compact and cost-effective regimens including at least two and often three fully active agents. The emergence of drug-resistant HIV is expected to continue to become less frequent in the future, driven by improvements in the convenience, tolerability, efficacy, and durability of first-line HAART regimens. To continue this trend, the optimal rollout of HAART in both rich and resource-limited settings will require careful planning and strategic use of antiretroviral drugs and monitoring technologies.http://dx.doi.org/10.1155/2012/595762
spellingShingle Marianne Harris
Bohdan Nosyk
Richard Harrigan
Viviane Dias Lima
Calvin Cohen
Julio Montaner
Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future
AIDS Research and Treatment
title Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future
title_full Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future
title_fullStr Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future
title_full_unstemmed Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future
title_short Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future
title_sort cost effectiveness of antiretroviral therapy for multidrug resistant hiv past present and future
url http://dx.doi.org/10.1155/2012/595762
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