{"id":238,"date":"2009-01-13T08:46:25","date_gmt":"2009-01-13T13:46:25","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=238"},"modified":"2009-01-13T08:46:25","modified_gmt":"2009-01-13T13:46:25","slug":"can-we-have-too-many-options","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/can-we-have-too-many-options\/2009\/01\/13\/","title":{"rendered":"Can We Have &#8220;Too Many Options?&#8221;"},"content":{"rendered":"<p>As part of our regular series &#8220;Antiretroviral Rounds&#8221; in <em>AIDS Clinical Care<\/em>, today we <a href=\"http:\/\/aids-clinical-care.jwatch.org\/cgi\/content\/full\/2009\/112\/1\" target=\"_blank\">post a case<\/a> of a highly treatment-experienced patient with dreaded &#8220;triple class&#8221; resistance &#8212; that is, resistance to NRTIs, NNRTIs, and PIs.<\/p>\n<p>The good news now, of course, is that we have more than these three drug classes.<\/p>\n<p>The tough part is choosing what to use, as often with so many new options we&#8217;re designing regimens that have not been extensively tested in prospective studies.\u00a0 (Or tested at all &#8212; for example, <em>no <\/em>patient in the <a href=\"http:\/\/content.nejm.org\/cgi\/content\/short\/359\/14\/1429\" target=\"_blank\">maraviroc MOTIVATE studies<\/a> received darunavir; today I&#8217;d suspect nearly every patient on this drug is on darunavir.)<\/p>\n<p>We asked three highly-experienced HIV specialists what they&#8217;d do for a patient like this with &#8220;too many options&#8221; &#8212; raltegravir-naive, R5 tropic virus, susceptibility to both etravirine and darunavir &#8212; and perhaps not surprisingly, we got three different answers.<\/p>\n<p>Further input to management of this case is welcome, of course.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As part of our regular series &#8220;Antiretroviral Rounds&#8221; in AIDS Clinical Care, today we post a case of a highly treatment-experienced patient with dreaded &#8220;triple class&#8221; resistance &#8212; that is, resistance to NRTIs, NNRTIs, and PIs. The good news now, of course, is that we have more than these three drug classes. The tough part [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,4,8],"tags":[266,339,423,587,779,801],"class_list":["post-238","post","type-post","status-publish","format-standard","hentry","category-antiretroviral-rounds","category-hiv","category-patient-care","tag-darunavir","tag-etravirine","tag-hiv","tag-maraviroc","tag-raltegravir","tag-resistance"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/238","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=238"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/238\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=238"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=238"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=238"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}