Journal
ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA
Volume 32, Issue 7, Pages 447-458Publisher
EDICIONES DOYMA S A
DOI: 10.1016/j.eimc.2014.02.018
Keywords
Antiretroviral treatment; Human immunodeficiency virus infection; AIDS; Guideline; Recommendations; Antiretroviral drugs; Adverse reactions; GeSIDA; Spanish National AIDS Plan
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In this update, antiretroviral therapy (ART) is recommended for all patients infected by type 1 human immunodeficiency virus (HIV-1). The strength and grade of the recommendation varies with clinical circumstances, number of CD4 cells, comorbid conditions and prevention of transmission of HIV. The objective of ART is to achieve an undetectable plasma viral load. Initial ART should always comprise a combination of 3 drugs, including 2 nucleoside reverse transcriptase inhibitors and a third drug from a different family (non-nucleoside reverse transcriptase inhibitor, protease inhibitor, or integrase inhibitor). This update presents the causes and criteria for switching ART in patients with undetectable plasma viral load and in cases of virological failure. An update is also provided for the specific criteria for ART in special situations (acute infection, HIV-2 infection, and pregnancy) and with comorbid conditions (tuberculosis or other opportunistic infections, kidney disease, liver disease, and cancer). (C) 2014 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.
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