Factors that predict success in HIV treatment include selection of the appropriate treatment for your patients, adherence to the prescribed regimen, and retention in care.

DERRICK BUTLER, MD: So, I have another question in terms of your practices. What have you found to be the predictors of virologic success in your patients?

CYNTHIA RIVERA, MD: It’s really about two things: how well the patient understands the importance of taking the medicine every day, as well as the regimen itself. So, really, as we get to know our patients, we do things like get our labs and see what the viral load is, how high is the viral load—maybe it’ll take a little bit longer to get our viral loads undetectable with higher viral loads, how well can the patient tolerate the regimen and assure that this will be something they’ll be able to take every day without any interruptions. 

LEANDRO MENA, MD: I think an important factor in building a successful therapeutic plan is really work with the patient, understanding the patient’s life, schedules. I mean, sometimes we assume. We, in life, have routines, we tend to do things at certain times, but when I talk to many of my patients, I ask, you know, tell me one thing you do every day around the same time; there’s nothing. So how do you integrate this into their regular life and how do you help them to build and need for at least this one thing, you have to take every day or at the same time? So, you want to make sure that whatever regimen you develop for the patient is something that fits their lifestyle. 

DERRICK BUTLER, MD: If the patient is starting with a low baseline viremia at onset, they’re more likely to reach undetectable levels. And also patients on a high-potency antiretroviral regimen should be able to reach that treatment goal also. I think, too, really, getting the patient to be on a regimen that actually adheres to their lifestyle, that actually fits into their daily activities so that they can remain adherent to their medications, which we know is a key to reaching virologic suppression. And, of course, that regimen being tolerable for the patient to take too.