Patients with HIV infection are at risk for increasing viral replication, CD4 cell declines, disease progression and death if untreated. Highly Active Antiretroviral Therapy (HAART) is often complicated by difficulties with adherence and drug toxicity. The current gold standard for most HIV+ patients includes a triple combination of a protease inhibitor (PI) and two nucleoside reverse transcriptase inhibitors (NRTIs). However, not all patients respond completely and suffer disease progression due to incomplete suppression of HIV replication and emergence of viral resistance. Recent studies with triple combinations of protease sparing regimens of two NRTIs and a non-nucleoside RTIs (NNRTIs - such as delavirdine, efavirenz) have also shown good viral suppression but the durability is still being investigated. The reason for investigating protease inhibitor sparing regimens is that once resistance develops to a single protease inhibitor, the possibility of cross resistance to all protease inhibitors exists.
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