Failure of first line & Switching to second line HIV therapy (VE01)

There is a major ongoing effort to provide HIV infected patients with access to antiretroviral therapy (ART), especially in resource-limited regions. However, patients are at substantial risk of failing their initial ART treatment. Treatment failure is defined as the progression of the disease after a patient has been initiated on ART, and can be assessed using clinical, immunological and virologic criteria. The true extent of treatment failure is unknown, but one study in South Africa found that 8-17% of patients failed on first-line ART after 5 years. Two key causes of treatment failure are lack of adherence and drug resistance. To improve patient outcomes it is crucial to identify patients who experience treatment failure and to initiate second-line therapy.
While there has been a great effort to provide ART to people living with HIV in resource-limited settings, many who experience treatment failure go unrecognized and hence are not timely switched to second-line therapy. The reasons for this may include:

- Challenges in identifying patients who experience treatment failure due to lack of routine viral monitoring (sometimes due to poor laboratory infrastructure, no regular viral load testing and limited access to resistance testing)
- High costs and limited availability of second-line treatment options
- Lack of training and knowledge of healthcare professionals to switch patients to effective second-line treatment

Delayed switching to second-line therapy increases the risk of drug resistance, opportunistic infections and mortality among people living with HIV. Therefore, timely switching to second-line treatment is essential. This online course will inform healthcare professionals about second-line treatment options and guidelines, so that they gain knowledge and confidence for their daily practice.

This HIV Clinical Masterclass program will consist of six modules: Three introductory webcast presentations about failure and treatment switching, provided by Nicholas Paton (Singapore) and Mark Boyd (Australia); and three clinical case studies discussed by Francois Venter (South Africa), Nicholas Paton (Singapore) and Jonathan Schapiro (Israel). The modules cover the most important aspects of virological failure and when and how patients should be switched to second line treatment (guidelines and recommendations and results of important studies).

After following this course, you will be able to:
- Define treatment failure and identify the risk factors for failure
- List second-line treatment options and guidelines
- Summarize important results from clinical trials on second-line treatment
- Describe the challenges regarding second line-treatment in the context of your own clinical practice and discuss how these challenges can be addressed

Upon completion of the course we will issue a certificate.

The first three modules (introductory modules) of the course Failure of First Line & Switching to Second Line HIV Therapy, made available on and organized by Virology Education, is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to provide the following CME activity for medical specialists. Each medical specialist should claim only those credits that he/she actually spent in the educational activity. The EACCME is an institution of the European Union of Medical Specialists (UEMS). Only those e-learning materials that are displayed on the UEMSEACCME website have formally been accredited.
Through an agreement between the European Union of Medical Specialists (UEMS) and the American Medical Association (AMA), physicians may convert EACCME credits to an equivalent number of AMA PRA Category 1 CreditsTM. Information on the process to convert EACCME credit to AMA credit can be found at

In case you have any questions regarding the program please contact us through the course platform or via

This program is funded in part via an independent grant from AbbVie.
  • Module 1: Virological Failure
  • Module 1 Learning objectives
  • Module 1 Pre-test
  • Module 1: Virological Failure
  • Module 1 Post-test
  • Feedback Module 1
  • MODULE 2: Switching to Second Line
  • Module 2 Learning objectives
  • Module 2 Pre-test
  • Module 2: Switching to second line
  • Module 2 Post-test
  • Feedback Module 2
  • MODULE 3: Future of second line therapy
  • Module 3 Learning objectives
  • Module 3 Pre-test
  • Module 3: Future of second line therapy
  • Module 3 Post-test
  • Feedback Module 3
  • Module 4: Clinical case 1
  • Module 4 Learning objectives
  • Module 4 - Pre-test
  • Module 4 Clinical Case by Jonathan Schapiro
  • Module 4 - Post-test
  • Feedback Module 4
  • Module 5: Clinical case 2
  • Module 5 Learning objectives
  • Module 5 - Pre-test
  • Module 5 - Clinical Case by Nicholas Paton
  • Module 5 - Post-test
  • Feedback Module 5
  • Module 6: Clinical case 3
  • Module 6 Learning objectives
  • Module 6 Pre-test
  • Module 6 Clinical Case by Francois Venter
  • Module 6 Post-test
  • Feedback Module 6
  • course evaluation
  • Course evaluation
Completion rules
  • You must complete the units "Module 1 Learning objectives, Module 1 Pre-test, Module 1 Post-test, Feedback Module 1, Module 2 Learning objectives, Module 2 Pre-test, Module 2 Post-test, Feedback Module 2, Module 3 Learning objectives, Module 3 Pre-test, Module 3 Post-test, Feedback Module 3, Module 4 - Pre-test, Module 4 - Post-test, Feedback Module 4, Module 5 Learning objectives, Module 5 - Pre-test, Feedback Module 5, Module 6 Learning objectives, Module 6 Pre-test, Module 6 Post-test"
  • Leads to a certification with a duration: Forever