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人类免疫缺陷病毒感染的抗逆转录病毒治疗:2016年瑞典建议

Antiretroviral treatment for HIV infection: Swedish recommendations 2016.

作者信息

Eriksen Jaran, Albert Jan, Blaxhult Anders, Carlander Christina, Flamholc Leo, Gisslén Magnus, Josephson Filip, Karlström Olof, Navér Lars, Svedhem Veronica, Yilmaz Aylin, Sönnerborg Anders

机构信息

a Department of Clinical Pharmacology , Karolinska University Hospital and Division of Clinical Pharmacology and Department of Laboratory Medicine, Karolinska Institutet , Stockholm , Sweden.

b Department of Microbiology, Tumor and Cell Biology , Karolinska Institutet and Department of Clinical Microbiology, Karolinska University Hospital , Stockholm , Sweden.

出版信息

Infect Dis (Lond). 2017 Jan;49(1):1-34. doi: 10.1080/23744235.2016.1247495. Epub 2016 Nov 2.

Abstract

The Swedish Medical Products Agency and the Swedish Reference Group for Antiviral Therapy (RAV) have jointly published recommendations for the treatment of HIV infection on seven previous occasions (2002, 2003, 2005, 2007, 2009, 2011 and 2014). In February 2016, an expert group under the guidance of RAV once more revised the guidelines. The most important updates in the present guidelines are as follows: Tenofovir alafenamide (TAF) has recently been registered. TAF has several advantages over tenofovir disoproxilfumarate (TDF) and is recommended instead of TDF in most cases. First-line treatment for previously untreated individuals includes dolutegravir, boosted darunavir or efavirenz with either abacavir/lamivudine or tenofovir (TDF/TAF)/emtricitabine. Pre-exposure prophylaxis (PrEP) is recommended for high-risk individuals. As in the case of the previous publication, recommendations are evidence-graded in accordance with the Oxford Centre for Evidence Based Medicine ( http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/ ) ( Table 1 ). This document does not cover treatment of opportunistic infections and tumours. [Table: see text].

摘要

瑞典医疗产品管理局和瑞典抗病毒治疗参考小组(RAV)此前已联合发布过七次关于HIV感染治疗的建议(分别在2002年、2003年、2005年、2007年、2009年、2011年和2014年)。2016年2月,在RAV指导下的一个专家组再次修订了指南。本指南中最重要的更新如下:替诺福韦艾拉酚胺(TAF)最近已获批上市。TAF相对于富马酸替诺福韦二吡呋酯(TDF)有多个优势,在大多数情况下推荐使用TAF而非TDF。既往未接受治疗个体的一线治疗包括多替拉韦、增强型达芦那韦或依非韦伦,联合阿巴卡韦/拉米夫定或替诺福韦(TDF/TAF)/恩曲他滨。推荐对高危个体进行暴露前预防(PrEP)。与上一版发布情况相同,建议按照牛津循证医学中心(http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/)进行证据分级(表1)。本文档不涵盖机会性感染和肿瘤的治疗。[表:见正文]

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