HIV can become resistant to antiretroviral drugs, particularly if adherence is poor or intermittent. The presence of drug-resistant virus allows HIV to replicate, reducing CD4 cell count, and increasing the risk of illness and death. A recent large retrospective study has shown that there has been a significant fall in the proportion of HIV-positive people in Western Europe with experience of HIV treatment who have resistance to multiple antiretroviral drugs. The prevalence of triple-class resistance peaked at just below 5% in 2005 before falling, and in 2008 at most 1% of patients had exhausted their treatment options. This adds confidence to the idea that modern HIV treatment with recently developed HIV drugs (taken properly, as prescribed) can be successful for a lifetime.

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