• We recommend for individuals experiencing virological failure on first-line ART with WT virus at baseline and without emergent resistance mutations at failure, switch to a PI/r-based combination ART regimen is the preferred option.
  • We recommend individuals experiencing virological failure on first-line ART with WT virus at baseline and limited emergent resistance mutations (including two-class NRTI/NNRTI) at failure, switch to a new PI/r-based regimen with the addition of at least one, preferably two, active drugs.
  • We recommend individuals experiencing virological failure on first-line PI/r plus two-NRTI-based regimens, with limited major protease mutations, switch to a new active PI/r with the addition of at least one, preferably two, active agents of which one has a novel mechanism of action.
  • We recommend against switching a PI/r to an INI or NNRTI as the third agent in individuals with historical or existing RT mutations associated with NRTI resistance or past virological failure on NRTIs.