Background: Multi-class HIV-1 resistant variants are not rare nowadays. Genotypic and phenotypic resistance testing (including virtual phenotype) constitutes an important tool for optimizing antiretroviral treatment.
Aim: To report a case of discrepancy between resistance interpretation and virological outcome.
Methods: A case of a multi-drug experienced patient is presented. Genotypic and/or virtual phenotypic testing analysis was used.
Results: The patient after 10 years of antiretroviral therapy with 11 different regimens unable to produce full virological suppression and with a rapidly declining CD4 count, achieved a successful virological outcome with a scheme containing Tipranavir boosted with low dose of ritonavir. Of note, the patient was screened for Tipranavir 1182.48 study and was found ineligible after genotypic analysis.
Conclusions: Virologic suppression was achieved despite the fact that neither an active agent was included in the backbone regimen nor the resistance profile could ensure the effectiveness of Tipranavir.