Santos Gil Ignacio de los
Hospital Universitario de la Princesa, Madrid, España.
Enferm Infecc Microbiol Clin. 2009 Dec;27 Suppl 2:40-5. doi: 10.1016/S0213-005X(09)73218-5.
The choice of antiretroviral treatment in comorbidities requires thorough knowledge of the interactions, pharmacokinetics and adverse effects of the drug to be used. Most drugs carry some risk in certain processes associated or not with HIV infection and drugs that can be used in these situations are of great interest. The development of etravirine, a new non-nucleoside reverse transcriptase inhibitor, will allow its use in these processes, with a lower risk of secondary effects and therefore of worsening the course of the disease and of treatment withdrawal. This is the case of patients coinfected with active hepatitis B and/or C virus and patients with a history of psychiatric disorders or receiving psychotropic drugs. The possible use of etravirine in women of fertile age is also of interest, due to the lower risk of teratogenicity if pregnancy occurs during treatment. Other collectives, such as patients with renal insufficiency or children and adolescents should not be forgotten; although these populations are less well studied, data are beginning to become available.
合并症患者抗逆转录病毒治疗方案的选择需要全面了解所用药物的相互作用、药代动力学和不良反应。大多数药物在某些与HIV感染相关或无关的过程中都存在一定风险,而可用于这些情况的药物备受关注。新型非核苷类逆转录酶抑制剂依曲韦林的研发,将使其能够用于这些过程,且副作用风险较低,从而降低疾病进展和治疗中断的风险。这适用于合并活动性乙型和/或丙型肝炎病毒感染的患者,以及有精神疾病病史或正在服用精神药物的患者。由于治疗期间怀孕时致畸风险较低,依曲韦林在育龄女性中的潜在应用也值得关注。其他群体,如肾功能不全患者以及儿童和青少年也不应被忽视;尽管对这些人群的研究较少,但已有数据开始出现。