160 Treatment Strategies to Minimize the Impact of Antiretroviral Drug Toxicities

Treatment success with antiretroviral drug regimens continues to improve. However, as HIV infected patients live longer, the clinician and patient are challenged with managing the complications of numerous co-morbidities and drug toxicities. While some of these problems may not be able to be prevented, the availability of multiple new antiretroviral agents now gives the clinician and patient multiple options to achieve virologic suppression. This raises the question of which combinations of antiretroviral agents have optimal safety and toxicity profiles for the individual patient. The potential implications of the choice and usage of certain antiretroviral agents and regimens and their known and potential advantages and disadvantages/toxicities will be reviewed and the avenues for further investigation will be highlighted. The complexities of managing an HIV infected patient today, including co-morbidities and antiretroviral drug toxicities, suggest that newer treatment strategies which reevaluate the factors and considerations that influence how antiretroviral agents and regimens are chosen may well move away from the currently recommended regimens in the future to attain the goal of minimization of long-term antiretroviral toxicities.