Carpenter C C, Cooper D A, Fischl M A, Gatell J M, Gazzard B G, Hammer S M, Hirsch M S, Jacobsen D M, Katzenstein D A, Montaner J S, Richman D D, Saag M S, Schechter M, Schooley R T, Thompson M A, Vella S, Yeni P G, Volberding P A
Brown University School of Medicine, Providence, RI 02906, USA.
JAMA. 2000 Jan 19;283(3):381-90. doi: 10.1001/jama.283.3.381.
To update recommendations for antiretroviral therapy for adult human immunodeficiency virus type 1 (HIV-1) infection, based on new information and drugs that are available.
A 17-member international physician panel with antiretroviral research and HIV patient care experience initially convened by the International AIDS Society-USA in December 1995.
Available clinical and basic science data including phase 3 controlled trials; data on clinical, virologic, and immunologic end points; research conference reports; HIV pathogenesis data; and panel expert opinion. Recommendations were limited to therapies available (US Food and Drug Administration approved) in 1999.
The panel assesses new research reports and interim results and regularly meets to consider how the new data affect therapy recommendations. Recommendations are updated via full-panel consensus. Guidelines are presented as recommendations if the supporting evidence warrants routine use in the particular situation and as considerations if data are preliminary or incomplete but suggestive.
The availability of new antiretroviral drugs has expanded treatment choices. The importance of adherence, emerging long-term complications of therapy, recognition and management of antiretroviral failure, and new monitoring tools are addressed. Optimal care requires individualized management and ongoing attention to relevant scientific and clinical information in the field.
根据可获得的新信息和药物，更新针对成人1型人类免疫缺陷病毒（HIV-1）感染的抗逆转录病毒治疗建议。
一个由17名医生组成的国际专家小组，他们具有抗逆转录病毒研究和HIV患者护理经验，最初由美国国际艾滋病协会于1995年12月召集。
可用的临床和基础科学数据，包括3期对照试验；临床、病毒学和免疫学终点数据；研究会议报告；HIV发病机制数据；以及专家小组的意见。建议仅限于1999年可用的疗法（美国食品药品监督管理局批准）。
专家小组评估新的研究报告和中期结果，并定期开会考虑新数据如何影响治疗建议。建议通过专家小组的共识进行更新。如果支持证据保证在特定情况下常规使用，则指南以建议的形式呈现；如果数据是初步的或不完整但具有提示性，则以考虑因素的形式呈现。
新抗逆转录病毒药物的出现扩大了治疗选择。文中讨论了坚持治疗的重要性、治疗中出现的长期并发症、抗逆转录病毒治疗失败的识别与管理以及新的监测工具。最佳护理需要个体化管理，并持续关注该领域的相关科学和临床信息。
