Epidemiology of treatment failure: a focus on recent trends
Bibliographic record
Abstract
PURPOSE OF REVIEW: As antiretroviral therapy has been refined with the development of more potent agents and simpler regimens, fewer individuals experience treatment failure. This review will highlight recent trends in treatment failure and virologic resistance in the developed world and resource-limited settings. RECENT FINDINGS: The goal of antiretroviral therapy in all individuals, regardless of prior treatment exposure or HIV drug resistance, is to achieve full suppression of viral replication with a viral load of less than 50 copies/ml. This goal has been made a reality by the development of newer agents and simpler, better tolerated regimens. Recent cohort studies have demonstrated improved virologic outcomes in the current antiretroviral era, with decreased rates of virologic failure and associated resistance. Improved tolerability has aided adherence, which remains a key determinant of treatment success. Cohorts in resource-limited settings report improved clinical and virologic outcomes as rollout of highly active antiretroviral therapy programs continues. SUMMARY: There has been a reassuring decrease in the frequency of virological failure and drug resistance in the modern highly active antiretroviral therapy era. This observation provides an important incentive to strengthen support of antiretroviral therapy programs to optimize virological outcomes, particularly in resource-limited settings in which access to newer agents and laboratory monitoring may be needed to ensure sustainable success.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".