{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T09:05:33Z","timestamp":1784883933503,"version":"3.55.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Gilead Sciences"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:p>While once-daily single-tablet regimens (STRs) are recommended for most people with human immunodeficiency virus (HIV; PWH), some require complex antiretroviral (ARV) regimens due to resistance, contraindications, or drug\u2013drug interactions. We characterized PWH who were virologically suppressed on complex regimens (VS on CR) in a U.S. cohort to inform treatment optimization as new switch options emerge. This retrospective study analyzed electronic medical records from the Trio Health HIV Network and genotypic resistance data from Labcorp. We included PWH \u2265 18 years who were virologically suppressed (viral load [VL] &lt; 200 copies\/mL) at complex regimen initiation between January 2016 and November 2023, with \u22656 months from last prescription and \u22651 year of follow-up. Complex regimens included \u22652 of 3 core ARV classes concomitantly, more than once-daily dosing, multi-tablet regimens (MTRs) not replaceable by STRs, or resistance to two ARV classes. Virologic failure (VF) was defined as VL \u2265 500 copies\/mL or two consecutive VLs \u2265 200 copies\/mL. PWH on ibalizumab, fostemsavir, or lenacapavir were excluded to reflect standard clinical practice. Of 43,236 PWH with ARV prescriptions, 3,320 (8%) were VS on CR. Among these, 69% were on MTRs, 43% used \u22652 core ARV classes, and 11% had resistance to two classes. The median age was 52 years, and 77% were male. Common comorbidities included obesity (69%), neuropsychiatric disorders (35%), and cardiovascular disease (33%). Regimens predominantly included protease inhibitors (77%), nucleoside reverse transcriptase inhibitors (75%), and integrase strand transfer inhibitors (57%). Over a median 2.2-year follow-up, 4% experienced VF. Approximately 8% of PWH on ART remain VS on CR, underscoring the need for education on regimen optimization and novel treatment options for those unable to simplify their therapy.<\/jats:p>","DOI":"10.1177\/10872914261455402","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T06:07:45Z","timestamp":1780639665000},"page":"297-306","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["People with HIV Continuing on Complex Regimens in the Era of Treatment Optimization: Characteristics and Outcomes"],"prefix":"10.1177","volume":"40","author":[{"given":"Paul E.","family":"Sax","sequence":"first","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith J.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Gilead Sciences, Foster City, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janna","family":"Radtchenko","sequence":"additional","affiliation":[{"name":"Trio Health, Louisville, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhumi","family":"Gandhi-Patel","sequence":"additional","affiliation":[{"name":"Gilead Sciences, Foster City, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2245-3507","authenticated-orcid":false,"given":"Isobel","family":"McEwen","sequence":"additional","affiliation":[{"name":"Trio Health, Louisville, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seojin","family":"Park","sequence":"additional","affiliation":[{"name":"Gilead Sciences, Foster City, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Walworth","sequence":"additional","affiliation":[{"name":"Laboratory Corporation of America, \u00ae Holdings, Burlington, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph J.","family":"Eron","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Benson","sequence":"additional","affiliation":[{"name":"Be Well, Berkley, Michigan, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karam","family":"Mounzer","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Pennsylvania; Philadelphia Fight Community Health Centers, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Ruhs","sequence":"additional","affiliation":[{"name":"Chase Brexton Health Care, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moti","family":"Ramgopal","sequence":"additional","affiliation":[{"name":"Midway Immunology and Research Center, Fort Pierce, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Santiago","sequence":"additional","affiliation":[{"name":"Care Resource, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Elion","sequence":"additional","affiliation":[{"name":"Trio Health, Louisville, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents. 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