Ryom L, Boesecke C, Gisler V, Manzardo C, Rockstroh J K, Puoti M, Furrer H, Miro J M, Gatell J M, Pozniak A, Behrens G, Battegay M, Lundgren J D
CHIP, Rigshospitalet, University Hospital of Copenhagen, Department of Infectious Diseases, Section 2100, Finsencentret, University of Copenhagen, Copenhagen, Denmark.
Department of Medicine, University of Bonn, Bonn, Germany.
HIV Med. 2016 Feb;17(2):83-8. doi: 10.1111/hiv.12322. Epub 2015 Nov 8.
The European AIDS Clinical Society (EACS) guidelines are intended for all clinicians involved in the care of HIV-positive persons, and are available in print, online, and as a free App for download for iPhone and Android.
The 2015 version of the EACS guidelines contains major revisions in all sections; antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Among the key revisions is the recommendation of ART for all HIV-positive persons, irrespectively of CD4 count, based on the Strategic Timing of AntiRetroviral Treatment (START) study results. The recommendations for the preferred and the alternative ART options have also been revised, and a new section on the use of pre-exposure prophylaxis (PrEP) has been added. A number of new antiretroviral drugs/drug combinations have been added to the updated tables on drug-drug interactions, adverse drug effects, dose adjustment for renal/liver insufficiency and for ART administration in persons with swallowing difficulties. The revisions of the coinfection section reflect the major advances in anti-hepatitis C virus (HCV) treatment with direct-acting antivirals with earlier start of treatment in individuals at increased risk of liver disease progression, and a phasing out of interferon-containing treatment regimens. The section on opportunistic diseases has been restructured according to individual pathogens/diseases and a new overview table has been added on CD4 count thresholds for different primary prophylaxes.
The diagnosis and management of HIV infection and related coinfections, opportunistic diseases and comorbidities continue to require a multidisciplinary effort for which the 2015 version of the EACS guidelines provides an easily accessable and updated overview.
欧洲艾滋病临床学会（EACS）指南面向所有参与HIV阳性患者护理的临床医生，有印刷版、在线版，还可作为免费应用程序供iPhone和安卓用户下载。
2015年版EACS指南在所有章节都有重大修订；抗逆转录病毒治疗（ART）、合并症、合并感染和机会性疾病。关键修订内容包括，根据抗逆转录病毒治疗时机战略（START）研究结果，建议对所有HIV阳性患者进行ART治疗，无论其CD4细胞计数如何。首选和替代ART方案的建议也有所修订，新增了关于暴露前预防（PrEP）使用的章节。在药物相互作用、药物不良反应、肾功能/肝功能不全时的剂量调整以及吞咽困难患者的ART给药等更新表格中，增加了一些新的抗逆转录病毒药物/药物组合。合并感染章节的修订反映了抗丙型肝炎病毒（HCV）治疗方面的重大进展，即使用直接作用抗病毒药物，对肝病进展风险增加的个体更早开始治疗，并逐步淘汰含干扰素的治疗方案。机会性疾病章节已根据个体病原体/疾病进行了重组，并新增了一个关于不同初级预防措施的CD4细胞计数阈值的概述表。
HIV感染及相关合并感染、机会性疾病和合并症的诊断与管理仍需多学科协作，2015年版EACS指南为此提供了易于获取且更新的概述。
