QT Interval Prolongation and Antiretroviral Treatment: Another Point of Interest

(COLATE) trial [8] indicated that the use of lamivudine in a salvage regimen after virological failure of a lamivudine-containing combination did not provide greater virological benefit than a salvage regimen without lamivudine when the aim is for complete viral suppression is aimed. We demonstrated that 48% of patients for whom an initial regimen of stavudine, lamivudine, and nevirapine failed would have limited options for second-line therapy using the drugs that are available in Thailand; this number increased to 63% among patients with late detection of treatment failure, and decreased to 30% among patients with early detection of treatment failure. To preserve future options for the second-line regimen in patients who experience treatment failure with a stavudine, lamivudine, and nevirapine regimen, the HIV-1 RNA assay is an important tool. This tool, as well as antiretroviral therapy, must be made more accessible in resource-limited environments.