On the whole, we are uncomfortable about trials that simply add one new agent to a failing regimen - a sort of “virtual monotherapy”
Such designs may not only provide inadequate care, provoking rapid viral resistance,but may prejudice later treatment options.
Intensification as a basic principle of therapy has an inherent futility. We are already hearing reports of patients taking eight or nine drugs as “Mega-HAART”. How many people can tolerate this? For how long?