Maintaining Viral Suppression in HIV: Insights on Switching Treatments and Emerging Agents

A panelist discusses how viral suppression in HIV patients means achieving undetectable virus levels (below 50 or 20 copies per ml), which prevents immune system damage and transmission to others, summarized as "undetectable equals untransmissible" (U=U).

A panelist discusses how the HIV patient population has aged significantly, with the average age in their clinic now exceeding 50 years and expected to soon exceed 65 years, and how these aging patients experience more comorbidities at younger ages than the general population while their HIV becomes easier to manage with simple regimens.

A panelist discusses how a new drug combination of doravirine and islatravir was compared to a standard bictegravir-based therapy in patients with HIV, showing noninferiority with over 90% of patients maintaining viral suppression without excess toxicity.

A panelist discusses how the new doravirine and islatravir combination offers an alternative to integrase inhibitor-based therapies, particularly useful for patients with integrase inhibitor resistance or adverse reactions, although clinicians may struggle with determining the ideal patient population.

A panelist discusses how the injectable combination of cabotegravir and rilpivirine performed well in the real-world OPERA cohort, with over 95% of patients maintaining virologic suppression. However, adherence to injection schedules remains a challenge, with only 62% receiving injections on time.

A panelist discusses how CD4 counts serve as measures of immune system status that typically increase by about 200 in the first year of antiretroviral therapy. Although there can be laboratory variability, these counts remain important for patient monitoring and identifying those at risk for complications.

A panelist discusses how HIV treatment has evolved with tremendous improvements in efficacy, tolerability, and convenience, with exciting developments at the Conference on Retroviruses and Opportunistic Infections 2025, including new long-acting therapies for treatment and prevention that could last up to 2 years.