Division of Infectious Diseases, Weill Medical College of Cornell University, New York, NY 10065, USA.
J Acquir Immune Defic Syndr. 2010 Dec;55 Suppl 1(Suppl 1):S43-8. doi: 10.1097/QAI.0b013e3181f9c09e.
Effective antiretroviral therapy (ART) changes the clinical course of HIV infection. There are 25 antiretroviral drugs approved for the treatment of HIV infection, and current antiretroviral drug regimens are highly effective, convenient, and relatively nontoxic. ART regimens should be chosen in consideration of a patient's particular clinical situation. Successful treatment is associated with durable suppression of HIV viremia over years, and consequently, ART reduces the risk of clinical progression. In fact, current models estimate that an HIV-infected individual appropriately treated with antiretroviral drugs has a life expectancy that approaches that of the general HIV-uninfected population, although some patient groups such as injection drug users do less well. Despite these advances, continued questions about ART persist: What is the optimal time to start ART? What is the best regimen to start? When is the optimal time to change ART? What is the best regimen to change to? In addition, newer antiretroviral agents are in development, both in existing classes and in new classes such as the CD4 receptor attachment inhibitors and the maturation inhibitors. Further research will help optimize current antiretroviral treatments and strategies.
有效的抗逆转录病毒疗法（ART）改变了 HIV 感染的临床进程。目前有 25 种抗逆转录病毒药物被批准用于治疗 HIV 感染，并且当前的抗逆转录病毒药物方案非常有效、方便且相对无毒。ART 方案的选择应考虑患者的具体临床情况。成功的治疗与多年来 HIV 病毒血症的持久抑制有关，因此，ART 降低了临床进展的风险。事实上，目前的模型估计，接受抗逆转录病毒药物适当治疗的 HIV 感染者的预期寿命接近未感染 HIV 的一般人群，尽管一些患者群体，如注射吸毒者，情况较差。尽管取得了这些进展，但关于 ART 的持续问题仍然存在：何时开始 ART 最佳？开始的最佳方案是什么？何时是改变 ART 的最佳时机？改变的最佳方案是什么？此外，新的抗逆转录病毒药物正在开发中，包括现有类别和新类别，如 CD4 受体附着抑制剂和成熟抑制剂。进一步的研究将有助于优化当前的抗逆转录病毒治疗和策略。
