Unité hospitalière de recherche, d'enseignement et de soins sur le sida (UHRESS), Centre hospitalier de l'Université de Montréal;
Can J Infect Dis Med Microbiol. 2011 Summer;22(2):52-60. doi: 10.1155/2011/169045.
The appropriate use of antiretrovirals reduces morbidity and mortality caused by HIV infection. The present article provides health care professionals with a practical guide for the use of antiretrovirals. Therapy should be initiated based predominantly on clinical presentation and CD4 count, and should consist of three active drugs or at least two active drugs when this is not possible, as in cases of some treatment-experienced patients. This is the most effective way to achieve long-term suppression of viral replication. Selection of individual drugs in the regimen should consider the weight of the evidence supporting these choices, as well as their tolerability profiles and ease of use, the patients' comorbidities and treatment history. Treatment interruption is not recommended, either in aviremic patients or in those who have experienced virological failure. Instead, the therapeutic regimen should be adjusted to minimize side effects, promote adherence and suppress viral replication.
抗逆转录病毒药物的合理使用可降低由 HIV 感染引起的发病率和死亡率。本文为医疗保健专业人员提供了抗逆转录病毒药物使用的实用指南。治疗应主要根据临床表现和 CD4 计数来启动，并应包含三种活性药物，或者在某些治疗经验丰富的患者无法使用两种以上活性药物时使用至少两种活性药物。这是实现长期抑制病毒复制的最有效方法。方案中个体药物的选择应考虑支持这些选择的证据权重，以及它们的耐受性和易用性、患者的合并症和治疗史。不建议中断治疗，无论是在病毒载量抑制的患者还是经历病毒学失败的患者中。相反，应调整治疗方案以最大程度减少副作用、提高患者的依从性并抑制病毒复制。
