Target Audience

This activity is intended for infectious disease and HIV specialists engaged in the care of patients with HIV.

Program Description

Virologic failure (VF) is common among patients with HIV. It has numerous potential causes, including patient-related, HIV-related, and antiretroviral therapy (ART)-related factors. Clinicians need to be familiar with how to interpret resistance mutations and create subsequent regimens based on individual patient characteristics. Dr. Laura Waters and Dr. Anna Maria Geretti review the potential reasons for VF, when to perform resistance testing, the utility of proviral DNA testing, the interpretation of mutations, and clinical trial data from switch studies that include resistance mutations.

Educational Objectives

After completing this activity, the participant should be better able to:

  • Address the challenges faced when selecting subsequent ART regimens in patients experiencing virologic failure


Anna Maria Geretti, MD, PhD, FRCPath
Professor of Infectious Diseases
Department of Infectious Diseases, Fondazione PTV
Faculty of Medicine
University of Rome Tor Vergata
Rome, Italy

Laura Waters, MD, FRCP
Consultant Physician, Sexual Heath & HIV
Chair British HIV Association
Mortimer Market Centre
London, United Kingdom

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (PACE) and Integritas Communications.  PACE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education

PACE designates this enduring activity for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The maximum number of hours awarded for this Continuing Nursing Education activity is 0.25 contact hours.

Disclosure of Conflicts of Interest

PACE requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose all financial relationships they may have with ineligible companies. All relevant financial relationships are thoroughly vetted and mitigated according to PACE policy. PACE is committed to providing learners with high-quality accredited CE activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.

The faculty reported the following relevant financial relationships with ineligible entities related to the educational content of this CME/CE activity:

Anna Maria Geretti, MD, PhD, FRCPath
Consulting Fees/Advisor/Speaker: Gilead Sciences, Inc., GlaxoSmithKline plc, Janssen Pharmaceuticals, Inc., PeerVoice, Theratechnologies Europe Limited, ViiV Healthcare, Virology Education
Researcher: Roche Diagnostics International Ltd
Expert scientist: Roche Pharma Research and Development
Editor-in-Chief: British Medical Journal (BMJ)-Sexually Transmitted Infections Journal

Laura Waters, MD, FRCP: 
Consulting Fees/Advisor/Speaker: Cipla Limited, Gilead Sciences, Inc., Janssen Pharmaceuticals, Inc., Merck & Co, Inc., Mylan Pharmaceuticals, Inc., Theratechnologies Inc., ViiV Healthcare
Researcher: Gilead Sciences, Inc., Janssen Pharmaceuticals, Inc., ViiV Healthcare

The PACE planners and others have nothing to disclose. The Integritas Communications planners and others have nothing to disclose.

Instructions to Receive Credit

To receive credit for this activity, participants must complete the preactivity questionnaire, complete and receive a minimum score of 100% on the posttest, and complete the program evaluation.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.  The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners.  Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development.  The information presented in this activity is not meant to serve as a guideline for patient management.  Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

Fee Information

There is no fee for this educational activity.

CME Questions – PACE Contact Information

For information about the accreditation of this program, please contact PACE

Integritas Contact Information

For all other questions regarding this activity, please contact Integritas via email at

System Requirements

1.4 GHz Intel Pentium 4 or faster processor (or equivalent)
Windows 10, 8.1 (32-bit/64-bit), Windows 7 (32-bit/64-bit)
512 MB of RAM (1 GB recommended)
Microsoft Internet Explorer 11 or later, Windows Edge browser, Mozilla Firefox, and Google Chrome
For HTML Client – Google Chrome (v70.0 & above), Mozilla Firefox (v65.0 & above), and Edge (v42.0 & above)

1.83 GHz Intel Core Duo or faster processor
512 MB of RAM (1 GB recommended)
MAC OS X 10.12, 10.13 and 10.14
Mozilla Firefox, Apple Safari, Google Chrome
For HTML Client – Google Chrome (v70.0 & above), Apple Safari (v12.0 & above), and Mozilla Firefox (v65.0 & above)

Begin Activity
available resources
linked resources
Suggested Reading

Answers to Everyday Practice Challenges in HIV Medicine

A Phone-a-Friend CME Series – Volume 2