Executive summary of the GESIDA/National AIDS Plan Consensus Document on antiretroviral therapy in adults infected by the human immunodeficiency virus (updated January 2015)

Autores de IIS La Fe

• Joaquin Berenguer Lapuerta

  Autor

• José López Aldeguer

  Autor

• Fernando Lozano

  Autor

• Pere Domingo Pedrol

  Autor

• Tatiana Fernandez Portilla

  Autor

• Esteban Ribera Pascuet

  Autor

• Jaime Sanz Caballer

  Autor

Participantes ajenos a IIS La Fe

• Expert Panel of GESIDA and the National AIDS Plan
• Polo R
• Aguirrebengoa K
• Arribas JR
• Blanco JR
• Boix V
• Casado JL
• Clotet B
• Crespo M
• Estrada V
• García F
• Gatell JM
• González-García J
• Gutiérrez F
• Iribarren JA
• Knobel H
• Llibre JM
• Locutura J
• López JC
• Miró JM
• Moreno S
• Podzamczer D
• Pulido F
• Riera M
• Rubio R
• Santos J
• Sanz-Moreno J
• Téllez MJ
• Tuset M
• Rivero A

Grupos

• Hematología y Hemoterapia

  

  Investigador Principal

  Javier De La Rubia Comos

• Investigacion clínica en enfermedades crónicas e Infección por el VIH

  Investigador Principal

  Marta Montero Alonso

Abstract

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 vary depending on the CD4+ T-lymphocyte count, the presence of opportunistic infections or comorbid conditions, age, and the efforts to prevent the transmission of HIV. The objective of ART is to achieve an undetectable plasma viral load (PVL). Initial ART should comprise three drugs, namely, two nucleoside reverse transcriptase inhibitors (NRTI) and one drug from another family. Three of the recommended regimens, all of which have an integrase strand transfer inhibitor (INSTI) as the third drug, are considered a preferred regimen; a further seven regimens, which are based on an INSTI, an non-nucleoside reverse transcriptase inhibitor (NNRTI), or a protease inhibitor boosted with ritonavir (PI/r), are considered alternatives. The reasons and criteria for switching ART are presented both for patients with an undetectable PVL and for patients who experience virological failure, in which case the rescue regimen should include three (or at least two) drugs that are fully active against HIV. The specific criteria for ART in special situations (acute infection, HIV-2 infection, pregnancy) and comorbid conditions (tuberculosis and other opportunistic infections, kidney disease, liver disease, and cancer) are updated. (C) 2015 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinics. All rights reserved.

Keywords

• Antiretroviral treatment; Human immunodeficiency virus infection; AIDS; Guideline; GESIDA; Spanish National AIDS Plan