Daar Eric S
David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.
Top HIV Med. 2008 Oct-Nov;16(4):110-6.
The antiretroviral treatment goal in highly treatment-experienced patients is now suppression of viral replication to undetectable levels, a goal that can be achieved by strategic use of combinations that include newer antiretroviral drugs. Newer drugs in established classes that improve virologic response when added to optimized background therapy include the protease inhibitors darunavir and tipranavir and the second-generation nonnucleoside analogue reverse transcriptase inhibitor etravirine. New drugs from new classes that have proved active in treatment-experienced patients include the chemokine coreceptor 5 (CCR5) antagonist maraviroc and the integrase strand-transfer inhibitor raltegravir. Knowledge of the resistance patterns and predictors of response with these new agents and careful selection of background therapy are crucial to maximizing virologic response and preventing emergence of resistance. This article summarizes a presentation on emerging resistance profiles of newer antiretroviral drugs made by Eric S. Daar, MD, at an International AIDS Society-USA Continuing Medical Education course in Los Angeles in March 2008. The original presentation is available as a Webcast at www.iasusa.org.
对于接受过大量治疗的患者，目前抗逆转录病毒治疗的目标是将病毒复制抑制到检测不到的水平，这一目标可通过合理使用包含新型抗逆转录病毒药物的联合疗法来实现。在已有的药物类别中，当添加到优化的背景治疗方案中时能改善病毒学应答的新型药物包括蛋白酶抑制剂地瑞那韦和替拉那韦，以及第二代非核苷类逆转录酶抑制剂依曲韦林。在接受过治疗的患者中已证明有效的新型药物类别中的新药包括趋化因子共受体5（CCR5）拮抗剂马拉维若和整合酶链转移抑制剂拉替拉韦。了解这些新型药物的耐药模式和应答预测指标，并谨慎选择背景治疗方案，对于最大化病毒学应答和预防耐药的出现至关重要。本文总结了医学博士埃里克·S·达阿尔于2008年3月在洛杉矶举行的美国国际艾滋病学会继续医学教育课程上所作的关于新型抗逆转录病毒药物新出现的耐药情况的报告。原始报告可在www.iasusa.org上作为网络直播观看。
