Casado José L, Moreno Santiago
Departamento de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España.
Enferm Infecc Microbiol Clin. 2013 Jun;31 Suppl 2:30-5. doi: 10.1016/S0213-005X(13)70140-X.
Antiretroviral simplification is a useful strategy to improve adherence and quality of life and prevent or reverse adverse effects in patients with HIV infection. The availability of new drugs with high efficacy and better tolerability in once-daily formulations or in fixed-dose combinations may be a better option for prolonged treatment. Rilpivirine, a new nonnucleoside reverse transcriptase inhibitor (NNRTI), has shown high antiviral efficacy in clinical trials with treatment-naïve patients, with a lower incidence of adverse effects and good tolerability. Its use in simplification regimens has been evaluated after the switch from efavirenz, demonstrating that dose adjustment is not required. In a large randomized study in patients who were receiving protease inhibitors, virological efficacy was maintained, with a lower incidence of adverse effects and improved lipid parameters and cardiovascular risk score. Given the ease of administration and good tolerability of this drug, recent communications at congresses have shown the rapid applicability of the results of studies in daily clinical practice in this scenario.
抗逆转录病毒治疗方案简化是一种有用的策略，可提高HIV感染患者的依从性和生活质量，并预防或逆转不良反应。新型药物具有高效能且每日一次剂型或固定剂量组合的耐受性更好，可能是长期治疗的更佳选择。利匹韦林是一种新型非核苷类逆转录酶抑制剂（NNRTI），在初治患者的临床试验中显示出高抗病毒疗效，不良反应发生率较低且耐受性良好。在从依非韦伦转换后，已对其在简化治疗方案中的应用进行了评估，结果表明无需调整剂量。在一项针对接受蛋白酶抑制剂治疗患者的大型随机研究中，病毒学疗效得以维持，不良反应发生率较低，脂质参数和心血管风险评分有所改善。鉴于该药物给药方便且耐受性良好，近期在大会上的交流表明，在此情况下，研究结果可迅速应用于日常临床实践。
