Van den Eynde Eva, Podzamczer Daniel
HIV Unit, Infectious Disease Service, Hospital Universitari de Bellvitge, c/Feixa Llarga s/n. L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
Expert Rev Anti Infect Ther. 2014 Sep;12(9):1055-74. doi: 10.1586/14787210.2014.944506. Epub 2014 Jul 30.
Despite great advances in antiretroviral therapy in the last decade, several limitations still remain such as adverse effects, lack of adherence and drug-drug interactions. Switching antiretroviral therapy in stable, virologically suppressed patients with the aim of improving tolerability and convenience is an expanding strategy in clinical practice. Several factors need to be taken into consideration when switching a suppressive regimen, such as previous virologic failure, genetic barrier of the new regimen, prior duration of virologic suppression and expected level of adherence. The most frequently used strategies include reductions in the number of pills, drugs or doses. Although switching strategies may be useful, not all the regimens used in clinical practice are based on data from randomized clinical trials and some may not be the best option for certain patients; therefore, therapy should be individualized taking into consideration available information as well as patient and drug characteristics.
尽管在过去十年抗逆转录病毒疗法取得了巨大进展，但仍存在一些局限性，如不良反应、依从性差和药物相互作用。在病毒学得到抑制的稳定患者中更换抗逆转录病毒疗法，以提高耐受性和便利性，这在临床实践中是一种不断扩展的策略。更换抑制性治疗方案时需要考虑几个因素，如既往病毒学失败情况、新方案的遗传屏障、既往病毒学抑制持续时间以及预期的依从性水平。最常用的策略包括减少药片、药物或剂量的数量。虽然更换策略可能有用，但临床实践中使用的并非所有方案都基于随机临床试验数据，有些可能对某些患者并非最佳选择；因此，应考虑现有信息以及患者和药物特征进行个体化治疗。
