Grinsztejn Beatriz, Coelho Lara E, Luz Paula M, Veloso Valdilea G
Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil.
J Virus Erad. 2017 Jul 1;3(3):111-116. doi: 10.1016/S2055-6640(20)30328-9.
Currently, immediate initiation of antiretroviral therapy (ART) is recommended for all individuals with HIV infection. However, among the 37 million people estimated to be living with HIV/AIDS, only 17 million are actively on treatment. Optimal use of ART among HIV-infected and at-risk individuals reduces morbidity, mortality, transmission and acquisition of HIV infection. ART regimen choices are affected by factors such as economic differences between resource-rich and low- and middle-income countries (LIMC), drug availability, and considerations for use in special populations. Ideal ART regimens combine high efficacy, high tolerability, low toxicity, low pill burden, affordability and global availability. Here, we highlight five aspects to be considered when thinking of an ideal global ART regimen: (1) the co-administration with other medications especially tuberculosis treatment; (2) treatment for specific populations such as women, children, adolescents, older people and acutely infected individuals; (3) efficacy; (4) safety, tolerability and convenience; and (5) affordability and global access for all PLWH.
目前，建议所有艾滋病毒感染者立即开始抗逆转录病毒治疗（ART）。然而，在估计的3700万艾滋病毒/艾滋病感染者中，只有1700万人正在积极接受治疗。在艾滋病毒感染者和高危人群中优化使用抗逆转录病毒治疗可降低发病率、死亡率、艾滋病毒感染的传播和感染率。抗逆转录病毒治疗方案的选择受到多种因素影响，如资源丰富国家与低收入和中等收入国家（LMIC）之间的经济差异、药物可及性以及特殊人群用药考虑等。理想的抗逆转录病毒治疗方案应具备高效、高耐受性、低毒性、低服药负担、可负担性以及全球可及性等特点。在此，我们强调在考虑理想的全球抗逆转录病毒治疗方案时应考虑的五个方面：（1）与其他药物特别是结核病治疗的联合使用；（2）针对特定人群的治疗，如妇女、儿童、青少年、老年人和急性感染者；（3）疗效；（4）安全性、耐受性和便利性；（5）所有艾滋病毒感染者的可负担性和全球可及性。
