Berenguer Juan, Polo Rosa, Lozano Fernando, López Aldeguer José, Antela Antonio, Arribas José Ramón, Asensi Víctor, Blanco José Ramón, Clotet Bonaventura, Domingo Pere, Galindo María José, Gatell José María, González-García Juan, Iribarren José Antonio, Locutura Jaime, López Juan Carlos, Mallolas Josep, Martínez Esteban, Miralles Celia, Miró José M, Moreno Santiago, Palacios Rosario, Pérez Elías María Jesús, Pineda Juan Antonio, Podzamczer Daniel, Portilla Joaquín, Pulido Federico, Ribera Esteban, Riera Melchor, Rubio Rafael, Santos Jesús, Sanz Jesús, Tuset Montserrat, Vidal Francesc, Rivero Antonio
Enferm Infecc Microbiol Clin. 2014 Aug-Sep;32(7):447-58. doi: 10.1016/j.eimc.2014.02.018. Epub 2014 Jun 28.
In this update, antiretroviral therapy (ART) is recommended for all patients infected by type 1 human immunodeficiency virus (HIV-1). The strength and grade of the recommendation varies with clinical circumstances, number of CD4 cells, comorbid conditions and prevention of transmission of HIV. The objective of ART is to achieve an undetectable plasma viral load. Initial ART should always comprise a combination of 3 drugs, including 2 nucleoside reverse transcriptase inhibitors and a third drug from a different family (non-nucleoside reverse transcriptase inhibitor, protease inhibitor, or integrase inhibitor). This update presents the causes and criteria for switching ART in patients with undetectable plasma viral load and in cases of virological failure. An update is also provided for the specific criteria for ART in special situations (acute infection, HIV-2 infection, and pregnancy) and with comorbid conditions (tuberculosis or other opportunistic infections, kidney disease, liver disease, and cancer).
在本次更新中，推荐对所有感染1型人类免疫缺陷病毒（HIV-1）的患者进行抗逆转录病毒治疗（ART）。推荐的力度和等级因临床情况、CD4细胞数量、合并症以及HIV传播的预防而有所不同。ART的目标是使血浆病毒载量检测不到。初始ART应始终包含3种药物的组合，包括2种核苷类逆转录酶抑制剂和来自不同类别（非核苷类逆转录酶抑制剂、蛋白酶抑制剂或整合酶抑制剂）的第三种药物。本次更新介绍了血浆病毒载量检测不到的患者以及病毒学失败情况下更换ART的原因和标准。还提供了特殊情况（急性感染、HIV-2感染和妊娠）以及合并症（结核病或其他机会性感染、肾脏疾病、肝脏疾病和癌症）下ART的具体标准更新。
