Those who had been extensively exposed to all three of the original classes also increased INCB024360 mw from 2383 (14% of ART-experienced patients) in 2000 to 8714 (19%) in 2007. The number of patients with ETCF increased over time in UK CHIC, from 62 patients in 2000 to 478 in 2007. This increase was observed in all risk groups. Based on this, the number of patients with ETCF in the United Kingdom was estimated to have increased from

147 (0.9%) patients in 2000 to 1771 (3.9%) patients in 2007 (Fig. 3). Of those who did experience ETCF, 75% had started ART with fewer than three drugs in 2000 and this decreased to 49% in 2007. In 2007, 11% of those who had started ART with fewer than three drugs experienced ETCF, compared with 2% of those who started with three or more drugs. The proportion of patients with ETCF who had unsuppressed viral load Everolimus in vivo decreased (from 80% in 2000 to 48% in 2007), meaning that the number of patients with ETCF and viral load >50 copies/mL is relatively stable. Model projections for 2012 suggest a continuation of these trends, with an estimated 3078 (uncertainty bounds 1714–5677) patients with ETCF, and 1168 (481–2908; 38% of the total with ETCF) with ETCF and viral load >50 copies/mL.

Amongst patients who had experienced ETCF seen for care in 2007, the most commonly used ‘new’ drugs were darunavir (8.6%), enfuvirtide (5.7%) and tipranavir (1.6%). Only 1% of patients had taken the CCR5 antagonist maraviroc and no patients had taken vicriviroc. Reported and projected numbers of deaths are shown in Figure 4. Modelled values are somewhat higher than numbers reported, but there is no apparent increasing trend in numbers of deaths, despite the increasing number of people infected with HIV, indicating a decrease in the death rate. The success of ART has improved markedly

over the period 2000–2007, with five in every six ART-treated patients having a viral load <50 copies/mL. Nine in 10 of all patients now have a CD4 count above the particularly high risk level of ADAMTS5 200 cells/μL. Trends among treated patients are likely to mirror those in other countries where the full range of antiretroviral drugs has been widely available. These trends have been accompanied by a steady increase in the extent of drug experience among patients. By 2007, 39% of patients had experienced the three original ART classes and the number with extensive triple class experience had increased from 2383 (14% of ART-experienced patients) in 2000 to 8714 (19%) in 2007. While the number of patients with extensive triple class virological failure has increased since 2000, and is projected to continue to rise, the percentage who do not have viral load suppression has decreased.