Article information
Objetivo
Efectuar una actualización de las recomendaciones sobre el tratamiento antiretroviral (TARV) de los adultos infectados por el VIH-1.
MétodosEstas recomendaciones se han consensuado por un panel del Grupo de Estudio de Sida y del Plan Nacional sobre el Sida. Se han revisado los avances en la fisiopatología del VIH-1, los resultados de eficacia y seguridad de ensayos clínicos, estudios de cohortes y de farmacocinética, publicados en revistas biomédicas o presentados en congresos en los últimos años. Se han definido tres niveles de evidencia según la procedencia de los datos: estudios aleatorizados (nivel A), de cohortes o de caso-control (nivel B), u opinión de expertos (nivel C). En cada una de las situaciones se ha establecido recomendar, considerar o no recomendar el TARV.
ResultadosActualmente, el TARV con combinaciones de tres fármacos constituye el tratamiento de inicio de elección de la infección crónica por el VIH-1. Estas pautas deben incluir 2 análogos de nucleósido o nucleótido (AN)+1 no análogo (NN) o 2 AN+ 1 inhibidor de la proteasa (IP) potenciado con ritonavir. En los pacientes con infección por VIH-1 sintomática se recomienda iniciar el TARV. En los pacientes asintomáticos el inicio de TARV se basará en la cifra de linfocitos CD4+/μl y en la carga viral plasmática (CVP): 1) en pacientes con linfocitos CD4+<200 células/μl se recomienda iniciar el TARV; 2) en pacientes con linfocitos CD4+ entre 200 y 350 células/μl en la mayoría de las ocasiones se debe recomendar el tratamiento, si bien se podría diferir cuando la cifra de linfocitos CD4+ se mantiene próxima a 350 células/μl y la CVP es baja; 3) en los pacientes con linfocitos CD4+>350 células/μl se puede diferir el inicio del TARV. El objetivo del TARV es lograr una carga viral plasmática indetectable. Las opciones terapéuticas en los fracasos del TARV se ven limitadas por la aparición de resistencias cruzadas. Los estudios genotípicos en estos casos son de utilidad. Se puede encontrar más información sobre los estudios analizados, las recomendaciones del panel sobre adherencia, toxicidad, tratamiento de la embarazada, pacientes coinfectados por VHB o VHC o sobre la profilaxis postexposición en la página web www.gesida.seimc.org.
ConclusionesLa cifra de linfocitos CD4+ es el factor de referencia más importante para iniciar el TARV en pacientes asintomáticos. Por otra parte, el número considerable de fármacos disponibles, los métodos más sensibles de monitorización de la CVP y la posibilidad de determinar las resistencias hacen que las estrategias terapéuticas deban ser cada vez más, mucho más individualizadas.
Palabras clave:
Tratamiento antirretroviral
Sida
Infección por VIH
GESIDA
PNS (Plan Nacional sobre el Sida)
Resistencia a antirretrovirales
Guía
Objective
This consensus document is an update of antiretroviral therapy (ART) recommendations for adult patients infected with the human immunodeficiency virus (HIV-1).
MethodsTo formulate these recommendations, a panel composed of members of the Grupo de Estudio de Sida (GESIDA; AIDS Study Group) and the Plan Nacional sobre el Sida (PNS; Spanish AIDS Plan) reviewed the advances in the current understanding of the pathophysiology of HIV, the safety and efficacy findings from clinical trials, and the results from cohort and pharmacokinetic studies published in biomedical journals or presented at scientific meetings over the last years. Three levels of evidence were defined according to the source of the data: randomized studies (level A), cohort or case-control studies (level B), and expert opinion (level C). The decision to recommend, consider or not recommend ART was established in each situation.
ResultsCurrently, the treatment of choice for chronic HIV infection is the combination of three drugs of two different classes, including 2 nucleosides or nucleotide analogs (NRTI) plus 1 non-nucleoside (NNRTI) or 1 boosted protease inhibitor (PI/r). Initiation of ART is recommended in patients with symptomatic HIV infection. In asymptomatic patients, initiation of ART is recommended on the basis of CD4+ lymphocyte counts and plasma viral load, as follows: 1) therapy should be started in patients with CD4+ counts of<;200 cells/μl; 2) therapy should be started in most patients with CD4+ counts of 200-350 cells/μl, although it can be delayed when CD4+ count persists at around 350 cells/μL and viral load is low, and 3) initiation of therapy can be delayed in patients with CD4+ counts of>350 cells/μL. The initial objective of ART is to achieve an undetectable viral load. Adherence to therapy plays an essential role in maintaining the antiviral response. Therapeutic options are limited with the development of cross resistance and ART failure. Genotype studies are useful in these cases. More information regarding the studies analyzed and the panel recommendations for adherence, toxicity, treatment during pregnancy, patients with hepatitis B or C virus co-infection, and post-exposure prophylaxis can be accessed at www.gesida.seimc.org
ConclusionsCD4+ lymphocyte count is the most important reference factor for initiating ART in asymptomatic patients. The large number of available drugs, the increased sensitivity of tests to monitor viral load, and the ability to determine viral resistance is leading to a more individualized approach to therapy.
Key words:
Antiretroviral treatment
AIDS
HIV infection
GESIDA
PNS (Plan Nacional sobre el Sida)
Antiretroviral resistance
Guidelines
Full text is only aviable in PDF
Bibliografía
[1.]
Panel on Clinical Practices for Treatment of HIV Infection convened by the U.S. Department of Health and Human Services (DHHS). Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents – Oct 10, 2006. http://www.AIDSinfo.nih.gov (Acceso 10.11.2006).
[2.]
B. Gazzard.
British HIV Association (BHIVA) guidelines for the treatment of HIV-infected adults with antiretroviral therapy (2005).
HIV Med, 6 (2005), pp. 1-61
[3.]
S.M. Hammer, M.S. Saag, M. Schechter, J.S. Montaner, R.T. Schooley, D.M. Jacobsen, et al.
Treatment for adult HIV infection: 2006 recommendations of the International AIDS Society-USA panel.
JAMA, 296 (2006), pp. 827-843
[4.]
J.A. Iribarren, P. Labarga, R. Rubio, J. Berenguer, J.M. Miro, A. Antela, et al.
Recomendaciones de GESIDA/Plan Nacional sobre el Sida respecto al tratamiento antirretroviral en pacientes adultos infectados por el virus de la inmunodeficiencia humana (Octubre 2004).
Enferm Infecc Microbiol Clin, 22 (2004), pp. 564-642
[5.]
J.C. Alberdi, D. López-Gay, A. Ferreras, E. Nieto.
Descenso brusco de la mortalidad por VIH-1/SIDA en la Comunidad de Madrid.
Med Clin (Barc), 110 (1998), pp. 679
[6.]
D.W. Cameron, M. Heath-Chiozzi, S. Danner, C. Cohen, S. Kravcik, C. Maurath, The Advanced HIV Disease Ritonavir Study Group, et al.
Randomized placebo-controlled trial of ritonavir in advanced HIV-1 disease.
Lancet, 351 (1998), pp. 543-549
[7.]
M.A. Fischl, D.D. Richman, M.H. Grieco, M.S. Gottlieb, P.A. Volberding, O.L. Laskin, et al.
The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo-controlled trial.
N Engl J Med, 317 (1987), pp. 185-191
[8.]
S.M. Hammer, K.E. Squires, M.D. Hughes, J.M. Grimes, L.M. Demeter, J.S. Currier, et al.
A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less. AIDS Clinical Trials Group 320 Study Team.
N Engl J Med, 337 (1997), pp. 725-733
[9.]
S.M. Hammer, D.A. KATVenstein, M.D. Hughes, H. Gundacker, R.T. Schooley, R.H. Haubrich, et al.
A trial comparing nucleoside monotherapy with combination therapy in HIV-infected adults with CD4 cell counts from 200 to 500 per cubic millimeter. AIDS Clinical Trials Group Study 175 Study Team.
N Engl J Med, 335 (1996), pp. 1081-1090
[10.]
A. Mocroft, S. Vella, T.L. Benfield, A. Chiesi, V. Miller, P. Gargalianos, EuroSIDA Study Group, et al.
Changing patterns of mortality across Europe in patients infected with HIV-1.
Lancet, 352 (1998), pp. 1725-1730
[11.]
Y. Mouton, S. Alfandari, M. Valette, F. Cartier, P. Dellamonica, G. Humbert, et al.
Impact of protease inhibitors on AIDS-defining events and hospitalizations in 10 French AIDS reference centres. Federation National des Centres de Lutte contre le SIDA.
AIDS, 11 (1997), pp. 101-105
[12.]
F.J. Palella Jr, K.M. Delaney, A.C. Moorman, M.O. Loveless, J. Fuhrer, G.A. Satten, et al.
Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators.
N Engl J Med, 338 (1998), pp. 853-860
[13.]
S. Paul, H.M. Gilbert, W. Ziecheck, J. Jacobs, K.A. Sepkowitz.
The impact of potent antiretroviral therapy on the characteristics of hospitalized patients with HIV infection.
AIDS, 13 (1999), pp. 415-418
[14.]
R.A. Torres, M. Barr.
Impact of combination therapy for HIV infection on inpatient census.
N Engl J Med, 336 (1997), pp. 1531-1532
[15.]
H. Knobel, I. Escobar, R. Polo, L. Ortega, M.T. Martín-Conde, J.L. Casado, et al.
Recomendaciones GESIDA/SEFH/PNS para mejorar la adherencia al tratamiento antirretroviral en el año 2004.
Enferm Infecc Microbiol Clin, 23 (2005), pp. 221-231
[16.]
A.D. Kelleher, A. Carr, J. Zaunders, D.A. Cooper.
Alterations in the immune response of human immunodeficiency virus (HIV)-infected subjects treated with an HIV-specific protease inhibitor, ritonavir.
J Infect Dis, 173 (1996), pp. 321-329
[17.]
P. Tebas, K. Henry, R. Nease, R. Murphy, J. Phair, W.G. Powderly.
Timing of antiretroviral therapy. Use of Markov modeling and decision analysis to evaluate the long-term implications of therapy.
AIDS, 15 (2001), pp. 591-599
[18.]
B. Autran, G. Carcelain, T.S. Li, C. Blanc, D. Mathez, R. Tubiana, et al.
Positive effects of combined antiretroviral therapy on CD4+ T cell homeostasis and function in advanced HIV disease.
Science, 277 (1997), pp. 112-116
[19.]
A. Carr, D.A. Cooper.
Adverse effects of antiretroviral therapy.
Lancet, 356 (2000), pp. 1423-1430
[20.]
K.A. Sepkowitz.
Effect of HAART on natural history of AIDS-related opportunistic disorders.
Lancet, 351 (1998), pp. 228-230
[21.]
B.E. Landon, I.B. Wilson, K. McInnes, M.B. Landrum, L.R. Hirschhorn, P.V. Marsden, et al.
Physician specialization and the quality of care for human immunodeficiency virus infection.
Arch Intern Med, 165 (2005), pp. 1133-1139
[22.]
M.A. Jacobson, M. Zegans, P.R. Pavan, J.J. O’Donnell, F. Sattler, N. Rao, et al.
Cytomegalovirus retinitis after initiation of highly active antiretroviral therapy.
Lancet, 349 (1997), pp. 1443-1445
[23.]
C. Michelet, C. Arvieux, C. Francois, J.M. Besnier, J.P. Rogez, J.P. Breux, et al.
Opportunistic infections occurring during highly active antiretroviral treatment.
AIDS, 12 (1998), pp. 1815-1822
[24.]
T.S. Li, R. Tubiana, C. Katlama, V. Calvez, H. Ait Mohand, B. Autran.
Long-lasting recovery in CD4 T-cell function and viral-load reduction after highly active antiretroviral therapy in advanced HIV-1 disease.
Lancet, 351 (1998), pp. 1682-1686
[25.]
S. Kostense, F.M. Raaphorst, D.W. Notermans, J. Joling, B. Hooibrink, N.G. Pakker, et al.
Diversity of the T-cell receptor BV repertoire in HIV-1-infected patients reflects the biphasic CD4+ T-cell repopulation kinetics during highly active antiretroviral therapy.
AIDS, 12 (1998), pp. 235-240
[26.]
J.C. López Bernaldo de Quirós, J.M. Miró, J.M. Pena, D. Podzamczer, J.C. Alberdi, E. Martínez, et al.
A randomized trial of the discontinuation of primary and secondary prophylaxis against Pneumocystis carinii pneumonia after highly active antiretroviral therapy in patients with HIV infection. Grupo de Estudio del SIDA 04/98.
N Engl J Med, 344 (2001), pp. 159-167
[27.]
S.G. Deeks, F.M. Hecht, M. Swanson, T. Elbeik, R. Loftus, P.T. Cohen, et al.
HIV RNA and CD4 cell count response to protease inhibitor therapy in an urban AIDS clinic: response to both initial and salvage therapy.
AIDS, 13 (1999), pp. 35-43
[28.]
D. Brambilla, P.S. Reichelderfer, J.W. Bremer, D.E. Shapiro, R.C. Hershow, D.A. KATVenstein, et al.
The contribution of assay variation and biological variation to the total variability of plasma HIV-1 RNA measurements. The Women Infant Transmission Study Clinics. Virology Quality Assurance Program.
AIDS, 13 (1999), pp. 2269-2279
[29.]
P.E. Sax, S.L. Boswell, M. White-Guthro, M.S. Hirsch.
Potential clinical implications of interlaboratory variability in CD4+ T-lymphocyte counts of patients infected with human immunodeficiency virus.
Clin Infect Dis, 21 (1995), pp. 1121-1125
[30.]
A. Lopez, I. Caragol, J. Candeias, N. Villamor, P. Echaniz, F. Ortuno, et al.
Enumeration of CD4(+) T-cells in the peripheral blood of HIV-infected patients: an interlaboratory study of the FACSCount system.
Cytometry, 38 (1999), pp. 231-237
[31.]
D.J. Kempf, R.A. Rode, Y. Xu, E. Sun, M.E. Heath-Chiozzi, J. Valdes, et al.
The duration of viral suppression during protease inhibitor therapy for HIV-1 infection is predicted by plasma HIV-1 RNA at the nadir.
AIDS, 12 (1998), pp. 9-14
[32.]
J.M. Raboud, J.S. Montaner, B. Conway, S. Rae, P. Reiss, S. Vella, et al.
Suppression of plasma viral load below 20 copies/ml is required to achieve a long-term response to therapy.
AIDS, 12 (1998), pp. 1619-1624
[33.]
L.M. Demeter, M.D. Hughes, R.W. Coombs, J.B. Jackson, J.M. Grimes, R.J. Bosch, et al.
Predictors of virologic and clinical outcomes in HIV-1-infected patients receiving concurrent treatment with indinavir, zidovudine, and lamivudine. AIDS Clinical Trials Group Protocol 320.
Ann Intern Med, 135 (2001), pp. 954-964
[34.]
W. Huang, G.V. De, M. Fischl, S. Hammer, D. Richman, D. Havlir, et al.
Patterns of plasma human immunodeficiency virus type 1 RNA response to antiretroviral therapy.
J Infect Dis, 183 (2001), pp. 1455-1465
[35.]
C. Hicks, M.S. King, R.M. Gulick, A.C. White Jr, J.J. Eron Jr, H.A. Kessler, et al.
Long-term safety and durable antiretroviral activity of lopinavir/ritonavir in treatment-naive patients: 4 year follow-up study.
AIDS, 18 (2004), pp. 775-779
[36.]
R.F. Siliciano.
Scientific rationale for antiretroviral therapy in 2005: viral reservoirs and resistance evolution.
Top HIV Med, 13 (2005), pp. 96-100
[37.]
R.E. Nettles, T.L. Kieffer, R.P. Simmons, J. Cofrancesco Jr, R.D. Moore, J.E. Gallant, et al.
Genotypic resistance in HIV-1-infected patients with persistently detectable low-level viremia while receiving highly active antiretroviral therapy.
Clin Infect Dis, 39 (2004), pp. 1030-1037
[38.]
G. Greub, A. Cozzi-Lepri, B. Ledergerber, S. Staszewski, L. Perrin, V. Miller, et al.
Intermittent and sustained low-level HIV viral rebound in patients receiving potent antiretroviral therapy.
AIDS, 16 (2002), pp. 1967-1969
[39.]
D.V. Havlir, R. Bassett, D. Levitan, P. Gilbert, P. Tebas, A.C. Collier, et al.
Prevalence and predictive value of intermittent viremia with combination HIV therapy.
JAMA, 286 (2001), pp. 171-179
[40.]
F.C. Lampe, M.A. Johnson, M. Lipman, C. Loveday, M. Youle, D. Ransom, et al.
Viral breakthrough after suppression with highly active antiretroviral therapy: experience from 233 individuals with viral loads of less than 50 copies/ ml followed for up to 4 years.
AIDS, 17 (2003), pp. 768-770
[41.]
J.A. Mira, J. Macías, C. Nogales, J. Fernández-Rivera, J.A. García-García, A. Ramos, et al.
Transient rebounds of low-level viraemia among HIV-infected patients under HAART are not associated with virological or immunological failure.
Antivir Ther, 7 (2002), pp. 251-256
[42.]
P.K. Lee, T.L. Kieffer, R.F. Siliciano, R.E. Nettles.
HIV-1 viral load blips are of limited clinical significance.
J Antimicrob Chemother, 57 (2006), pp. 803-805
[43.]
M.S. Saag, M. Holodniy, D.R. Kuritzkes, W.A. O’Brien, R. Coombs, E. Poscher M, et al.
HIV viral load markers in clinical practice.
Nat Med, 2 (1996), pp. 625-629
[44.]
M.S. Hirsch, F. Brun-Vezinet, B. Clotet, B. Conway, D.R. Kuritzkes, R.T. D’Aquila, et al.
Antiretroviral drug resistance testing in adults infected with human immunodeficiency virus type 1: 2003 recommendations of an International AIDS Society-USA Panel.
Clin Infect Dis, 37 (2003), pp. 113-128
[45.]
H.L. Devereux, M. Youle, M.A. Johnson, C. Loveday.
Rapid decline in detectability of HIV-1 drug resistance mutations after stopping therapy.
AIDS, 13 (1999), pp. 123-127
[46.]
R.M. Novak, L. Chen, R.D. MacArthur, J.D. Baxter, H.K. Huppler, G. Peng, et al.
Prevalence of antiretroviral drug resistance mutations in chronically HIV-infected, treatment-naive patients: implications for routine resistance screening before initiation of antiretroviral therapy.
Clin Infect Dis, 40 (2005), pp. 468-474
[47.]
A.M. Wensing, D.A. Van de Vijver, G. Angarano, B. Asjo, C. Balotta, E. Boeri, et al.
Prevalence of drug-resistant HIV-1 variants in untreated individuals in Europe: implications for clinical management.
J Infect Dis, 192 (2005), pp. 958-966
[48.]
P. Cane, I. Chrystie, D. Dunn, B. Evans, A.M. Geretti, H. Green, et al.
Time trends in primary resistance to HIV drugs in the United Kingdom: multicentre observational study.
BMJ, 331 (2005), pp. 1368
[49.]
M. Gómez-Cano, A. Rubio, T. Puig, M. Pérez-Olmeda, L. Ruiz, V. Soriano, et al.
Prevalence of genotypic resistance to nucleoside analogues in antiretroviral-naive and antiretroviral-experienced HIV-infected patients in Spain.
AIDS, 12 (1998), pp. 1015-1020
[50.]
T. Puig, M. Pérez-Olmeda, A. Rubio, L. Ruiz, C. Briones, J.M. Franco, The ERASE-2 Study Group, et al.
Prevalence of genotypic resistance to nucleoside analogues and protease inhibitors in Spain.
AIDS, 14 (2000), pp. 727-732
[51.]
M.C. De, C. Rodríguez, J. Colomina, C. Tuset, F. García, J.M. Eiros, et al.
Resistance to nonnucleoside reverse-transcriptase inhibitors and prevalence of HIV type 1 non-B subtypes are increasing among persons with recent infection in Spain.
Clin Infect Dis, 41 (2005), pp. 1350-1354
[52.]
M.C. De, C. Rodríguez, J.M. Eiros, J. Colomina, F. García, P. Leiva, et al.
Antiretroviral recommendations may influence the rate of transmission of drug-resistant HIV type 1.
Clin Infect Dis, 41 (2005), pp. 227-232
[53.]
P.E. Sax, R. Islam, R.P. Walensky, E. Losina, M.C. Weinstein, S.J. Goldie, et al.
Should resistance testing be performed for treatment-naive HIV-infected patients? A cost-effectiveness analysis.
Clin Infect Dis, 41 (2005), pp. 1316-1323
[54.]
F.M. Hecht, R.M. Grant.
Resistance testing in drug-naive HIV-infected patients: is it time?.
Clin Infect Dis, 41 (2005), pp. 1324-1325
[55.]
L.M. Mofenson, J.S. Lambert, E.R. Stiehm, J. Bethel, W.A. Meyer, J. Whitehouse, et al.
Risk factors for perinatal transmission of human immunodeficiency virus type 1 in women treated with zidovudine. Pediatric AIDS Clinical Trials Group Study 185 Team.
N Engl J Med, 341 (1999), pp. 385-393
[56.]
S.L. Welles, J. Pitt, R. Colgrove, K. McIntosh, P.H. Chung, A. Colson, The Women and Infants Transmission Study Group, et al.
HIV-1 genotypic zidovudine drug resistance and the risk of maternal-infant transmission in the women and infants transmission study.
AIDS, 14 (2000), pp. 263-271
[57.]
J. Stekler, A. Collier.
Treatment of Primary HIV.
Curr Infect Dis Rep, 4 (2002), pp. 81-87
[58.]
C.D. Pilcher, J.J. Eron Jr, S. Galvin, C. Gay, M.S. Cohen.
Acute HIV revisited: new opportunities for treatment and prevention.
J Clin Invest, 113 (2004), pp. 937-945
[59.]
S. Kassutto, E. Rosenberg.
Primary HIV Type 1 Infection.
Clin Infect Dis, 38 (2004), pp. 1452-1458
[60.]
A.C. Weintrob, J. Giner, P. Menezes, E. Patrick, D.K. Benjamin Jr, J. Lennox, et al.
Infrequent diagnosis of primary human immunodeficiency virus infection: missed opportunities in acute care settings.
Arch Intern Med, 163 (2003), pp. 2097-2100
[61.]
J.M. Miro, O. Sued, M. Plana, T. Pumarola, T. Gallart.
Avances en el diagnóstico y tratamiento de la infección aguda por el VIH-1.
Enferm Infecc Microbiol Clin, 22 (2004), pp. 643-659
[62.]
E.S. Daar, S. Little, J. Pitt, J. Santangelo, P. Ho, N. Harawa, et al.
Diagnosis of primary HIV-1 infection. Los Angeles County Primary HIV Infection Recruitment Network.
Ann Intern Med, 134 (2001), pp. 25-29
[63.]
S. Lindback, R. Thorstensson, A.C. Karlsson, M. Von Sydow, L. Flamholc, A. Blaxhult, Karolinska Institute Primary HIV Infection Study Group, et al.
Diagnosis of primary HIV-1 infection and duration of follow-up after HIV exposure.
AIDS, 14 (2000), pp. 2333-2339
[64.]
D.E. Smith, B.D. Walker, D.A. Cooper, E.S. Rosenberg, J.M. Kaldor.
Is antiretroviral treatment of primary HIV infection clinically justified on the basis of current evidence?.
AIDS, 18 (2004), pp. 709-718
[65.]
N. Voirin, D. Smith, J.P. Routy, M. Legault, D. Baratin, C. Trepo, et al.
Effect of treatment during versus after acute retroviral syndrome on HIV viral load and CD4 cell counts within 3 years of infection.
11th Conference on Retrovirus and Opportunistic Infections,
[66.]
S. Kassutto, K. Maghsoudi, M.N. Johnston, G.K. Robbins, N.C. Burgett, P.E. Sax, et al.
Longitudinal analysis of clinical markers following antiretroviral therapy initiated during acute or early HIV type 1 infection.
Clin Infect Dis, 42 (2006), pp. 1024-1031
[67.]
O. Sued, J.M. Miro, A. Alquezar, X. Claramonte, F. García, M. Plana, et al.
Primary human immunodeficiency virus type 1 infection: clinical, virological and immunological characteristics of 75 patients (1997-2003).
Enferm Infecc Microbiol Clin, 24 (2006), pp. 238-244
[68.]
J.P. Phair, J.W. Mellors, R. Detels, J.B. Margolick, A. Muñoz.
Virologic and immunologic values allowing safe deferral of antiretroviral therapy.
AIDS, 16 (2002), pp. 2455-2459
[69.]
A. Cozzi Lepri, A.N. Phillips, A. d’Arminio Monforte, F. Castelli, A. Antinori, A. De Luca, et al.
When to start highly active antiretroviral therapy in chronically HIV-infected patients: evidence from the ICONA study.
AIDS, 15 (2001), pp. 983-990
[70.]
A.N. Phillips, S. Staszewski, R. Weber, O. Kirk, P. Francioli, V. Miller, et al.
HIV viral load response to antiretroviral therapy according to the baseline CD4 cell count and viral load.
JAMA, 286 (2001), pp. 2560-2567
[71.]
E. Wood, R.S. Hogg, B. Yip, D. Moore, P.R. Harrigan, J.S. Montaner.
Impact of baseline viral load and adherence on survival of HIV-infected adults with baseline CD4 cell counts > or = 200 cells/microl.
AIDS, 20 (2006), pp. 1117-1123
[72.]
R.S. Hogg, B. Yip, K.J. Chan, E. Wood, K.J. Craib, M.V. O'Shaughnessy, et al.
Rates of disease progression by baseline CD4 cell count and viral load after initiating triple-drug therapy.
JAMA, 286 (2001), pp. 2568-2577
[73.]
E. Wood, R.S. Hogg, B. Yip, R. Quercia, P.R. Harrigan, M.V. O'Shaughnessy, et al.
Higher baseline levels of plasma human immunodeficiency virus type 1 RNA are associated with increased mortality after initiation of triple-drug antiretroviral therapy.
J Infect Dis, 188 (2003), pp. 1421-1425
[74.]
E. Wood, R.S. Hogg, B. Yip, P.R. Harrigan, M.V. O'Shaughnessy, J.S. Montaner.
Effect of medication adherence on survival of HIV-infected adults who start highly active antiretroviral therapy when the CD4+ cell count is 0.200 to 0.350 × 10(9) cells/L.
Ann Intern Med, 139 (2003), pp. 810-816
[75.]
J.E. Kaplan, D.L. Hanson, D.L. Cohn, J. Karon, S. Buskin, M. Thompson, et al.
When to begin highly active antiretroviral therapy? Evidence supporting initiation of therapy at CD4+ lymphocyte counts < 350 cells/microL.
Clin Infect Dis, 37 (2003), pp. 951-958
[76.]
T.R. Sterling, R.E. Chaisson, R.D. Moore.
HIV-1 RNA, CD4 T-lymphocytes, and clinical response to highly active antiretroviral therapy.
AIDS, 15 (2001), pp. 2251-2257
[77.]
J. Keruly, R. Moore.
Increases in CD4 cell count to 5 years in persons with sustained virologic suppression.
13th Conference on Retrovirus and Opportunistic Infection,
[78.]
J. Sterne, M. May, D. Costagliola, M. Egger, R. Hogg, A. D’Arminio Monforte, et al.
Estimating the optimum CD4 threshold for starting HAART in ART-naïve HIV-infected individuals.
13th Conference on Retrovirus and Opportunistic Infection,
[79.]
D.M. Moore, R.S. Hogg, B. Yip, K. Craib, E. Wood, J.S. Montaner.
CD4 percentage is an independent predictor of survival in patients starting antiretroviral therapy with absolute CD4 cell counts between 200 and 350 cells/microL.
HIV Med, 7 (2006), pp. 383-388
[80.]
Centers for Disease Control and Prevention.
1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults.
MMWR Recomm Rep, 41 (1992), pp. 1-19
[81.]
J.A. Bartlett, R. DeMasi, J. Quinn, C. Moxham, F. Rousseau.
Overview of the effectiveness of triple combination therapy in antiretroviral-naive HIV-1 infected adults.
AIDS, 15 (2001), pp. 1369-1377
[82.]
S.A. Riddler, R. Haubrich, G. DiRienzo, L. Peeples, W.G. Powderly, K.L. Klingman, et al.
A prospective, randomized, Phase III trial of NRTI-, PI-, and NNRTI-sparing regimens for initial treatment of HIV-1 infection-ACTG 5142.
XVI International AIDS Conference,
[83.]
M.S. King, B.M. Bernstein, S.L. Walmsley, R. Sherer, J. Feinberg, I. Sanne, et al.
Baseline HIV-1 RNA level and CD4 cell count predict time to loss of virologic response to nelfinavir, but not lopinavir/ritonavir, in antiretroviral therapy- naive patients.
J Infect Dis, 190 (2004), pp. 280-284
[84.]
F. Pulido, J.R. Arribas, J.M. Miró, M.A. Costa, J. González, R. Rubio, et al.
Clinical, virologic, and immunologic response to efavirenz or protease inhibitor based highly active antiretroviral therapy in a cohort of antiretroviral-naïve patients with advanced HIV infection (EfaVIP 2 Study).
J Acquir Immune Defic Syndr, 35 (2004), pp. 343-350
[85.]
J.M. Miro, J. Pich, M. Plana, P. Domingo, D. Podzamczer, J.R. Arribas, et al.
Immunological reconstitution in severely immunosuppressed antiretroviral-naive patients (< 100 CD4+ cells/mm3) using a non-nucleoside reverse transcriptase inhibitor-or a boosted protease inhibitor-based antiretroviral therapy regimen: 96-week results (the Advanz trial).
10th European AIDS Conference,
[86.]
H. Ribaudo, D.R. Kuritzkes, C. Lalama, J. Schouten, B. Schackman, R. Gulik, et al.
Efavirenz-based regimens are potent in treatment-naive subjects across a wide range of pre-treatment HIV-1 RNA and CD4 cell counts: 3-year results from ACTG 5095.
XVI International AIDS Conference,
[87.]
R.M. Gulick, H.J. Ribaudo, C.M. Shikuma, S. Lustgarten, K.E. Squires, W.A. Meyer III, et al.
Triple-Nucleoside Regimens versus Efavirenz-Containing Regimens for the Initial Treatment of HIV-1 Infection.
N Engl J Med, 350 (2004), pp. 1850-1861
[88.]
R. Van Leeuwen, C. Katlama, R.L. Murphy, K. Squires, J. Gatell, A. Horban, et al.
A randomized trial to study first-line combination therapy with or without a protease inhibitor in HIV-1-infected patients.
AIDS, 17 (2003), pp. 987-999
[89.]
S. Staszewski, P. Keiser, J. Montaner, F. Raffi, J. Gathe, V. Brotas, et al.
Abacavir-lamivudine-zidovudine vs indinavir-lamivudine-zidovudine in antiretroviral-naive HIV-infected adults: A randomized equivalence trial.
JAMA, 285 (2001), pp. 1155-1163
[90.]
S. Staszewski, J. Morales-Ramírez, K.T. Tashima, A. Rachlis, D. Skiest, J. Stanford, et al.
Efavirenz plus zidovudine and lamivudine, efavirenz plus indinavir, and indinavir plus zidovudine and lamivudine in the treatment of HIV-1 infection in adults. Study 006 Team.
N Engl J Med, 341 (1999), pp. 1865-1873
[91.]
C. Duvivier, J. Ghosn, L. Assoumou, C. Soulie, G. Peytavin, V. Calvez, et al.
Lower rate of virological suppression in naive patients initiating HAART with NRTI-sparing regimen compared to standard NRTI-containing regimen: results from Hippocampe – ANRS 121 Trial.
10th European AIDS Conference,
[92.]
M.A. Fischl, R. Bassett, A. Collier, L. Mukherjee, L. Demeter, P. Tebas, et al.
Randomized, controlled trial of lopinavir/ritonavir + efavirenz vs efavirenz + 2 nucleoside reverse transcriptase inhibitors following a first suppressive 3-or 4-drug regimen in advanced HIV disease.
12th Conference on Retroviruses and Opportunistic Infections,
[93.]
M. Markowitz, C. Hill-Zabala, J. Lang, E. DeJesus, Q. Liao, E.R. Lanier, et al.
Induction with abacavir/lamivudine/zidovudine plus efavirenz for 48 weeks followed by 48-week maintenance with abacavir/lamivudine/zidovudine alone in antiretroviral-naive HIV-1-infected patients.
J Acquir Immune Defic Syndr, 39 (2005), pp. 257-264
[94.]
R.W. Shafer, M.S. Smeaton, G.K. Robbins, V. De Gruttola, S.W. Snyder, R.T. D’ Aquila, et al.
Comparison of four-drug regimens and pairs of sequential three- drugs regimens as inicial therapy for HIV-1 infection.
N Engl J Med, 349 (2003), pp. 2304-2315
[95.]
R.M. Gulick, H.J. Ribaudo, C.M. Shikuma, C. Lalama, B.R. Schackman, W.A. Meyer III., et al.
Three-vs four-drug antiretroviral regimens for the initial treatment of HIV-1 infection: a randomized controlled trial.
JAMA, 296 (2006), pp. 769-781
[96.]
A.N. Phillips, D. Dunn, C. Sabin, A. Pozniak, R. Matthias, A.M. Geretti, et al.
Long term probability of detection of HIV-1 drug resistance after starting antiretroviral therapy in routine clinical practice.
AIDS, 19 (2005), pp. 487-494
[97.]
J.E. Gallant, E. DeJesús, J.R. Arribas, A.L. Pozniak, B. Gazzard, R.E. Campo, et al.
Tenofovir DF, emtricitabine, and efavirenz vs. zidovudine, lamivudine, and efavirenz for HIV.
N Engl J Med, 354 (2006), pp. 251-260
[98.]
J. Gallant, A. Pozniak, E. DeJesús, J. Arribas, R. Campo, S.S. Chen, et al.
Efficacy and safety of tenofovir DF, emtricitabine and efavirenz compared to fixed dose zidovudine/lamivudine and EFV through 96 weeks in antiretroviral treatment-naïve patients.
XVI International AIDS Conference,
[99.]
M.S. Saag, P. Cahn, F. Raffi, M. Wolff, D. Pearce, J.M. Molina, et al.
Efficacy and safety of emtricitabine vs stavudine in combination therapy in antiretroviral-naive patients: a randomized trial.
JAMA, 292 (2004), pp. 180-189
[100.]
Public Health Service Task Force Recommendations for the Use of Antiretroviral Drugs in Pregnant HIV-1 Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV-1 Transmission in the United Sta-tes, Oct 12, 2006. Disponible en: http://www.aidsinfo.nih.gov/guidelines/ (Acceso: 10.11.2006).
[101.]
A. León, E. Martínez, J. Mallolas, M. Laguno, J.L. Blanco, T. Pumarola, et al.
Early virological failure in treatment-naive HIV-infected adults receiving didanosine and tenofovir plus efavirenz or nevirapine.
AIDS, 19 (2005), pp. 213-215
[102.]
E. Negredo, A. Bonjoch, R. Paredes, J. Puig, B. Clotet.
Compromised immunologic recovery in treatment-experienced patients with HIV infection receiving both tenofovir disoproxil fumarate and didanosine in the TORO studies.
Clin Infect Dis, 41 (2005), pp. 901-905
[103.]
E. Martinez, A. Milinkovic, E. De Lazzari, G. Ravasi, J.L. Blanco, M. Larrousse, et al.
Pancreatic toxic effects associated with the co-administration of didanosine and tenofovir in HIV-infected adults.
Lancet, 364 (2004), pp. 65-67
[104.]
D. Podzamczer, E. Ferrer, J.M. Gatell, J. Niubo, D. Dalmau, A. León, et al.
Early virological failure with a combination of tenofovir, didanosine and efavirenz.
Antivir Ther, 10 (2005), pp. 171-177
[105.]
M.J. Pérez Elías, S. Moreno, C. Gutiérrez, D. López, V. Abraira, A. Moreno, et al.
MA. High virological failure rate in HIV patients after switching to a regimen with two nucleoside reverse transcriptase inhibitors plus tenofovir.
AIDS, 19 (2005), pp. 695-698
[106.]
J.J. Eron, E.S. Yetzer, P.J. Ruane, S. Becker, G.A. Sawyer, R.L. Fisher, et al.
Efficacy, safety, and adherence with a twice-daily combination lamivudine/zidovudine tablet formulation, plus a protease inhibitor, in HIV infection.
AIDS, 14 (2000), pp. 671-681
[107.]
E. DeJesús, G. Herrera, E. Teófilo, J. Gerstoft, C.B. Buendía, J.D. Brand, et al.
Abacavir versus zidovudine combined with lamivudine and efavirenz, for the treatment of antiretroviral-naive HIV-infected adults.
Clin Infect Dis, 39 (2004), pp. 1038-1046
[108.]
J.E. Gallant, S. Staszewski, A.L. Pozniak, E. DeJesús, J.M. Suleiman, M.D. Miller, et al.
Efficacy and safety of tenofovir DF vs stavudine in combination therapy in antiretroviral-naive patients: a 3-year randomized trial.
JAMA, 292 (2004), pp. 191-201
[109.]
M.A. Johnson, J.C. Gathe Jr, D. Podzamczer, J.M. Molina, C.T. Naylor, Y.L. Chiu, et al.
A Once-Daily Lopinavir/Ritonavir-Based Regimen Provides Noninferior Antiviral Activity Compared With a Twice-Daily Regimen.
J Acquir Immune Defic Syndr, 43 (2006), pp. 153-160
[110.]
F. Maggiolo, D. Ripamonti, G. Gregis, G. Quinzan, A. Callegaro, C. Arici, et al.
Once-a-day therapy for HIV infection: a controlled, randomized study in antiretroviral-naive HIV-1-infected patients.
Antivir Ther, 8 (2003), pp. 339-346
[111.]
D. Podzamczer, E. Ferrer, P. Sánchez, J. Gatell, M. Crespo, M. Lonca, et al.
A randomized comparison between abacavir and stavudine, both combined with lamivudine/efavirenz, in antiretroviral-naive patients. Final 96-week results of the ABCD Study.
12th Conference on Retrovirus and Opportunistic Infections,
[112.]
G. Moyle, C. Sabin, J. Cartledge, M. Jonhson, E. Wilkins, D. Churchill, et al.
A 48-week, randomized, open-label comparative study of tenofovir DF vs abacavir as substitutes for a thymidine analog in persons with lipoatrophy and sustained virological suppression on HAART.
12th Conference on Retrovirus and Opportunistic Infections,
[113.]
J. Gerstoft, O. Kirk, N. Obel, C. Pedersen, L. Mathiesen, H. Nielsen.
Low efficacy and high frequency of adverse events in a randomized trial of the triple NRTI regimen abacavir, stavudine and didanosine.
AIDS, 17 (2003), pp. 2045-2052
[114.]
J.A. Bartlett, J. Johnson, G. Herrera, N. Sosa, A.E. Rodríguez, M.S. Shaefer.
Abacavir/Lamivudine (ABC/3TC) in combination with Efavirenz (NNRTI), Amprenavir/Ritonavir (PI) or Stavudine (NRTI): ESS40001 (CLASS) preliminary 48 week results.
XIV International AIDS Conference,
[115.]
J.E. Gallant, A.E. Rodríguez, W. Weinberg, B. Young, D. Berger, M.L. Lim, et al.
Early Non-Response to Tenofovir DF (TDF) + Abacavir (ABC) and Lamivudine (3TC) in a Randomized Trial Compared to Efavirenz (EFV) + ABC and 3TC: ESS30009 Unplanned Interim Analysis.
43rd Interscience Conference on Antimicrobial Agents and Chemotherapy,
[116.]
Gilead. High rate of virologic failure in patients with HIV infection treated with a once-daily triple NRTI regimen containing didanosine, lamivudine, and tenofovir. Gilead Sciences, Inc., October 14, 2003.
[117.]
J.A. Iribarren, J.T. Ramos, L. Guerra, O. Coll, M.I. De José, P. Domingo, et al.
Prevención de la transmisión vertical y tratamiento de la infección por VIH-1 en la mujer embarazada. Recomendaciones de GESIDA-SEIMC, Asociación Española de Pediatría (AEP), Plan Nacional sobre el Sida y Sociedad Española de Ginecología y Obstetricia (SEGO).
Enferm Infecc Microbiol Clin, 19 (2001), pp. 314-335
[118.]
F. Van Leth, P. Phanuphak, K. Ruxrungtham, E. Baraldi, S. Miller, B. Gazzard, et al.
Comparison of first-line antiretroviral therapy with regimens including nevirapine, efavirenz, or both drugs, plus stavudine and lamivudine: a randomised open-label trial, the 2NN Study.
Lancet, 363 (2004), pp. 1253-1263
[119.]
G.K. Robbins, V. De Gruttola, R.W. Shafer, L.M. Smeaton, S.W. Snyder, C. Pettinelli, et al.
Comparison of secuential three-drug regimens as inicial therapy for HIV-1 infectión.
N Engl J Med, 349 (2003), pp. 2293-2303
[120.]
Montaner JSG, Schutz M, Schwartz R, Jayaweera D, Burnside AF, Walmsley S, et al. Efficacy, safety and pharmacokinetics of once-daily saquinavir soft-gelatin aapsule/ritonavir in antiretroviral-naive, HIV-infected patients. eJIAS http://www.medscape.com/viewarticle/528558 (acceso 10.11.06).
[121.]
R. Murphy, B. Da Silva, F. McMillan, C. Hicks, J. Eron, P. Wolfe, et al.
Seven year follow-up of a lopinavir/ritonavir-based regimen in antiretroviral-naïve subjects.
10th European AIDS Conference,
[122.]
W. Awni, Y. Chiu, L. Zhu, Y.L. Chiu, T. Zhu, N. Braun, et al.
Significantly reduced food effect and pharmacokinetic variability with a novel lopinavir/ ritonavir tablet formulation.
3rd IAS Conference on HIV Pathogenesis and Treatment,
[123.]
O. Kirk, T.L. KATVenstein, J. Gerstoft, L. Mathiesen, H. Nielsen, C. Pedersen, et al.
Combination therapy containing ritonavir plus saquinavir has superior short-term antiretroviral efficacy: a randomized trial.
AIDS, 13 (1999), pp. 9-16
[124.]
A. Rodríguez-French, J. Boghossian, G.E. Gray, J.P. Nadler, A.R. Quinones, G.E. Sepúlveda, et al.
The NEAT Study: A 48-week open-label study to compare the antiviral efficacy and safety of GW433908 versus nelfinavir in antiretroviral therapy naïve HIV-1-infected patients.
J Acquir Immune Defic Syndr, 35 (2004), pp. 22-32
[125.]
J.C. Gathe Jr, P. Ive, R. Wood, D. Schurmann, N.C. Bellos, E. DeJesús, et al.
SOLO: 48-week efficacy and safety comparison of once-daily fosamprenavir /ritonavir versus twice-daily nelfinavir in naive HIV-1-infected patients.
AIDS, 18 (2004), pp. 1529-1537
[126.]
I. Sanne, P. Piliero, K. Squires, A. Thiry, S. Schnittman.
Results of a phase 2 clinical trial at 48 weeks (AI424-007): a dose-ranging, safety, and efficacy comparative trial of atazanavir at three doses in combination with didanosine and stavudine in antiretroviral-naive subjects.
J Acquir Immune Defic Syndr, 32 (2003), pp. 18-29
[127.]
R.L. Murphy, I. Sanne, P. Cahn, P. Phanuphak, L. Percival, T. Kelleher, et al.
Dose-ranging, randomized, clinical trial of atazanavir with lamivudine and stavudine in antiretroviral-naive subjects: 48-week results.
AIDS, 17 (2003), pp. 2603-2614
[128.]
R. Wood, P. Phanuphak, P. Cahn, V. Pokrovskiy, W. Rozenbaum, G. Pantaleo, et al.
Long-Term Efficacy and Safety of Atazanavir With Stavudine and Lamivudine in Patients Previously Treated With Nelfinavir or Atazanavir.
J Acquir Immune Defic Syndr, 36 (2004), pp. 684-692
[129.]
N. Malan, E. Krantz, N. Davil, K. Kastango, D. Frederick, M. Matthew, et al.
Efficacy and safety of atazanavir-based therapy in antiretroviral naïve HIV-1 infected subjects, both with and without ritonavir: 48 week results from AI424-089.
13th Conference on Retrovirus and Opportunistic Infection,
[130.]
J. Eron Jr, P. Yeni, J. Gathe Jr, V. Estrada, E. DeJesús, S. Staszewski, et al.
The KLEAN study of fosamprenavir-ritonavir versus lopinavir-ritonavir, each in combination with abacavir-lamivudine, for initial treatment of HIV infection over 48 weeks: a randomised non-inferiority trial.
Lancet, 368 (2006), pp. 476-482
[131.]
G.M. Lucas, R.E. Chaisson, R.D. Moore.
Highly active antiretroviral therapy in a large urban clinic: risk factors for virologic failure and adverse drug reactions.
Ann Intern Med, 131 (1999), pp. 81-87
[132.]
B. Ledergerber, M. Egger, M. Opravil, A. Telenti, B. Hirschel, M. Battegay, et al.
Clinical progression and virological failure on highly active antiretroviral therapy in HIV-1 patients: a prospective cohort study. Swiss HIV Cohort Study.
Lancet, 353 (1999), pp. 863-868
[133.]
M.B. Klein, P. Willemot, T. Murphy, R.G. Lalonde.
The impact of initial highly active antiretroviral therapy on future treatment sequences in HIV infection.
AIDS, 18 (2004), pp. 1895-1904
[134.]
L. Gratacos, M. Tuset, C. Codina, J.M. Miró, J. Mallolas, N. Miserachs, et al.
Tratamiento antirretroviral de la infección por el virus de la inmunodeficiencia humana: duración y motivos de cambio del primer esquema terapéutico en 518 pacientes.
Med Clin (Barc), 126 (2006), pp. 241-245
[135.]
M.A. Wainberg, D. Turner.
Resistance issues with new nucleoside/nucleotide backbone options.
J Acquir Immune Defic Syndr, d37 (2004), pp. 36-43
[136.]
D.L. Paterson, S. Swindells, J. Mohr, M. Brester, E.N. Vergis, C. Squier, et al.
Adherence to protease inhibitor therapy and outcomes in patients with HIV infection.
Ann Intern Med, 133 (2000), pp. 21-30
[137.]
M.A. Chesney, J. Ickovics, F.M. Hecht, G. Sikipa, J. Rabkin.
Adherence: a necessity for successful HIV combination therapy.
AIDS, 13 (1999), pp. 271-278
[138.]
R.H. Haubrich, S.J. Little, J.S. Currier, D.N. Forthal, C.A. Kemper, G.N. Beall, California Collaborative Treatment Group, et al.
The value of patient-reported adherence to antiretroviral therapy in predicting virologic and immunologic response.
AIDS, 13 (1999), pp. 1099-1107
[139.]
S.J. Little, S. Holte, J.P. Routy, E.S. Daar, M. Markowitz, A.C. Collier, et al.
Antiretroviral-drug resistance among patients recently infected with HIV.
N Engl J Med, 347 (2002), pp. 385-394
[140.]
D. Bennett, A. Smith, W. Heneine, L. McCormick, I. Zaidi, G. García-Lerma, et al.
Geographic variation in prevalence of mutations associated with resistance to antiretroviral drugs among drug-naive persons newly diagnosed with HIV in ten US cities, 1997-2001.
2nd IAS Conference on HIV Pathogenesis and Treatment,
[141.]
A.N. Phillips, V. Miller, C. Sabin, A. Cozzi Lepri, S. Klauke, M. Bickel, et al.
Durability of HIV-1 viral suppression over 3.3 years with multi-drug antiretroviral therapy in previously drug-naive individuals.
AIDS, 15 (2001), pp. 2379-2384
[142.]
S.J.W. Cohen, A.M. Wensing, C. Kovacs, M. Righart, D. De Jong, S. Kaye, et al.
Transient relapses (“blips”) of plasma HIV RNA levels during HAART are associated with drug resistance.
J Acquir Immune Defic Syndr, 28 (2001), pp. 105-113
[143.]
S. Sungkanuparph, E.T. Overton, W. Seyfried, R.K. Groger, V.J. Fraser, W.G. Powderly.
Intermittent episodes of detectable HIV viremia in patients receiving nonnucleoside reverse-transcriptase inhibitor-based or protease inhibitor- based highly active antiretroviral therapy regimens are equivalent in incidence and prognosis.
Clin Infect Dis, 41 (2005), pp. 1326-1332
[144.]
K.A. Lichtenstein, C. Armon, A.C. Moorman, K.C. Wood, S.D. Holmberg.
A 7-year longitudinal analysis of IL-2 in patients treated with highly active antiretroviral therapy.
AIDS, 18 (2004), pp. 2346-2348
[145.]
J. López, J. Miró, S. Moreno, R. Rubio, B. Mahillo, C. Cifuentes, et al.
Interleukin- 2 as treatment for immunological discordant patietns with low CD4 cell counts alter at least one year of HAART-Gesidad33/03.
10th European AIDS Conference,
[146.]
J. Berenguer, J. Ribera Santasusana, R. Rubio, P. Miralles, B. Mahillo, M. Téllez, et al.
Characteristics and outcome of AIDS-related non-Hodgkin's lymphoma in patients treated with HAART.
13th Conference on Retrovirus and Opportunistic Infection,
[147.]
J.D. Baxter, D.L. Mayers, D.N. Wentworth, J.D. Neaton, M.L. Hoover, M.A. Winters, et al.
A randomized study of antiretroviral management based on plasma genotypic antiretroviral resistance testing in patients failing therapy. CPCRA 046 Study Team for the Terry Beirn Community Programs for Clinical Research on AIDS.
AIDS, 14 (2000), pp. 83-93
[148.]
J. Jemsek, P. Hutcherson, E. Harper.
Poor virologic responses and early emergence of resistance in treatment naive, HIV-infected patients receiving a once daily triple nucleoside regimen of didanosine, lamivudine, and tenofovir DF.
11th Conference on Retroviruses and Opportunistic Infections,
[149.]
R. Landman, G. Peytavin, D. Descamps, F. Brun Vezinet, H. Benech, A. Benalisherif, et al.
Low genetic barrier to resistance is a possible cause of early virologic failures in once-daily regimen of abacavir, lamivudine, and tenofovir: The Tonus study.
11th Conference on Retroviruses and Opportunistic Infections,
[150.]
D.A. KATVenstein, R.J. Bosch, N. Hellmann, N. Wang, L. Bacheler, M.A. Albrecht.
Phenotypic susceptibility and virological outcome in nucleoside-experienced patients receiving three or four antiretroviral drugs.
AIDS, 17 (2003), pp. 821-830
[151.]
R.W. Shafer, D. Stevenson, B. Chan.
Human Immunodeficiency Virus Reverse Transcriptase and Protease Sequence Database.
Nucleic Acids Res, 27 (1999), pp. 348-352
[152.]
V. Le Moing, G. Chene, M.P. Carrieri, A. Alioum, F. Brun-Vezinet, L. Piroth, et al.
Predictors of virological rebound in HIV-1-infected patients initiating a protease inhibitor-containing regimen.
AIDS, 16 (2002), pp. 21-29
[153.]
J. Durant, P. Clevenbergh, R. Garraffo, P. Halfon, S. Icard, P. Del Giudice, et al.
Importance of protease inhibitor plasma levels in HIV-infected patients treated with genotypic-guided therapy: pharmacological data from the Viradapt Study.
AIDS, 14 (2000), pp. 1333-1339
[154.]
R.M. Hoetelmans, M.H. Reijers, G.J. Weverling, R.W. Ten Kate, F.W. Wit, J.W. Mulder, et al.
The effect of plasma drug concentrations on HIV-1 clearance rate during quadruple drug therapy.
AIDS, 12 (1998), pp. 111-115
[155.]
A. Molla, M. Korneyeva, Q. Gao, S. Vasavanonda, P.J. Schipper, H.M. Mo, et al.
Ordered accumulation of mutations in HIV protease confers resistance to ritonavir.
Nat Med, 2 (1996), pp. 760-766
[156.]
C.A. Kemper, M.D. Witt, P.H. Keiser, M.P. Dube, D.N. Forthal, M. Leibowitz, et al.
Sequencing of protease inhibitor therapy: insights from an analysis of HIV phenotypic resistance in patients failing protease inhibitors.
AIDS, 15 (2001), pp. 609-615
[157.]
R. Colonno, R. Rose, C. McLaren, A. Thiry, N. Parkin, J. Friborg.
Identification of I50L as the signature atazanavir (ATV)-resistance mutation in treatment- naive HIV-1-infected patients receiving ATV-containing regimens.
J Infect Dis, 189 (2004), pp. 1802-1810
[158.]
J.H. Condra, C.J. Petropoulos, R. Ziermann, W.A. Schleif, M. Shivaprakash, E.A. Emini.
Drug resistance and predicted virologic responses to human immunodeficiency virus type 1 protease inhibitor therapy.
J Infect Dis, 182 (2000), pp. 758-765
[159.]
M. Bongiovanni, T. Bini, A. Capetti, S. Trovati, B.A. Di, F. Tordato, et al.
Long-term antiretroviral efficacy and safety of lopinavir/ritonavir in HAART-experienced subjects: 4 year follow-up study.
AIDS, 19 (2005), pp. 1934-1936
[160.]
C. De Mendoza, L. Martín-Carbonero, P. Barreiro, B. Díaz, E. Valencia, I. Jiménez- Nacher, et al.
Salvage treatment with lopinavir/ritonavir (Kaletra) in HIV-infected patients failing all current antiretroviral drug families.
HIV Clin Trials, 3 (2002), pp. 304-309
[161.]
J.J. Eron, J. Feinberg, H.A. Kessler, H.W. Horowitz, M.D. Witt, F.F. Carpio, et al.
Once-daily versus twice-daily lopinavir/ritonavir in antiretroviral-naïve HIV-positive patients: a 48-week randomized clinical trial.
J Infect Dis, 189 (2004), pp. 265-272
[162.]
A. Mocroft, A.N. Phillips, V. Miller, J. Gatell, J. Van Lunzen, J.M. Parkin, et al.
The use of and response to second-line protease inhibitor regimens: results from the EuroSIDA study.
AIDS, 15 (2001), pp. 201-209
[163.]
S.L. Walmsley, D.V. Kelly, A.L. Tseng, A. Humar, P.R. Harrigan.
Non-nucleoside reverse transcriptase inhibitor failure impairs HIV-RNA responses to efavirenz-containing salvage antiretroviral therapy.
AIDS, 15 (2001), pp. 1581-1584
[164.]
V. Latham, J. Stebbing, S. Mandalia, C. Michailidis, E. Davies, M. Bower, et al.
Adherence to trizivir and tenofovir as a simplified salvage regimen is associated with suppression of viraemia and a decreased cholesterol.
J Antimicrob Chemother, 56 (2005), pp. 186-189
[165.]
L. Elzi, H.H. Hirsch, M. Battegay.
Once-daily directly observed therapy lopinavir/ ritonavir plus indinavir as a protease inhibitor-only salvage therapy in heavily pretreated HIV-1-infected patients: a pilot study.
AIDS, 20 (2006), pp. 129-131
[166.]
J. Mitty, D. Mwamburi, G. Macalino, A. Caliendo, L. Bazerman, T. Flanigan.
Improved virologic outcomes and less HIV resistance for HAART-experienced substance users receiving modified directly observed therapy: results from a randomized controlled trial.
13th Conference on Retroviruses and Opportunistics Infections,
[167.]
F. Palella, C. Armon, J. Cmiel, K. Buchacz, R. Novak, A. Moorman, et al.
Enhanced survival associated with use of HIV susceptibility testing among HAART-experienced patients in the HIV Outpatient Study (HOPS).
13th Conference on Retroviruses and Opportunistics Infections,
[168.]
P. Barreiro, N. Camino, M.C. De, L. Valer, M. Núñez, L. Martín-Carbonero, et al.
Comparison of the efficacy, safety and predictive value of HIV genotyping using distinct ritonavir-boosted protease inhibitors.
Int J Antimicrob Agents, 20 (2002), pp. 438-443
[169.]
B. Best, M. Witt, M. Goicoechea, C. Kemper, R. Larsen, C. Diamond, et al.
Improved ART exposure with therapeutic drug monitoring.
13th Conference on Retroviruses and Opportunistics Infections,
[170.]
A. Winston, G. Hales, J. Amin, S.E. Van, D.A. Cooper, S. Emery.
The normalized inhibitory quotient of boosted protease inhibitors is predictive of viral load response in treatment-experienced HIV-1-infected individuals.
AIDS, 19 (2005), pp. 1393-1399
[171.]
B.A. Larder, K. Hertogs, S. Bloor, C.H. Van den Eynde, W. DeCian, Y. Wang, et al.
Tipranavir inhibits broadly protease inhibitor-resistant HIV-1 clinical samples.
AIDS, 14 (2000), pp. 1943-1948
[172.]
C.B. Hicks, P. Cahn, D.A. Cooper, S.L. Walmsley, C. Katlama, B. Clotet, et al.
Durable efficacy of tipranavir-ritonavir in combination with an optimized background regimen of antiretroviral drugs for treatment-experienced HIV-1-infected patients at 48 weeks in the Randomized Evaluation of Strategic Intervention in multi-drug reSistant patients with Tipranavir (RESIST) studies: an analysis of combined data from two randomised open-label trials.
Lancet, 368 (2006), pp. 466-475
[173.]
K. Arasteh, N. Clumeck, A. Pozniak, A. Lazzarin, M.S. De, H. Muller, et al.
TMC114/ritonavir substitution for protease inhibitor(s) in a non-suppressive antiretroviral regimen: a 14-day proof-of-principle trial.
AIDS, 19 (2005), pp. 943-947
[174.]
A. Lazzarin, F. Queiroz-Telles, I. Frank, J. Rockstroh, S. Walmsley, E. De Paepe, et al.
TMC114 provides durable viral load suppression in treatment- experienced patients: POWER 1 and 2 combined week 48 analysis.
XVI International AIDS Conference,
[175.]
M. Saag, R. Falcón, E. Lefebvre.
Efficacy and safety results of darunavir/r in treatment-experienced patients: POWER 3.
44th Annual meeting of the Infectious Disease Society of America,
[176.]
S. De Meyer, T. Vangeneugden, E. Lefebvre, H. Azijn, I. De Baere, B. Van Baelen, et al.
Phenotypic and genotypic determinants of resistance to TMC114: pooled analysis of POWER 1, 2 and 3.
XV International HIV Drug Resistance Workshop,
[177.]
J.P. Lalezari, K. Henry, M. O’Hearn, J.S. Montaner, P.J. Piliero, B. Trottier, et al.
Enfuvirtide, an HIV-1 fusion inhibitor, for drug-resistant HIV infection in North and South America.
N Engl J Med, 348 (2003), pp. 2175-2185
[178.]
A. Lazzarin, B. Clotet, D. Cooper, J. Reynes, K. Arasteh, M. Nelson, et al.
Efficacy of enfuvirtide in patients infected with drug-resistant HIV-1 in Europe and Australia.
N Engl J Med, 348 (2003), pp. 2186-2195
[179.]
C. Katlama, K. Arasteh, B. Clotet.
Enfuvirtide TORO studies: 48 week results confirm 24 week findings.
2nd IAS Conference on HIV Pathogenesis and Treatment,
[180.]
B. Trottieri, K. Arasteh, K. Henry, C. Katlama, A. Lazzarin, J. Montaner, et al.
Durability of Response of Enfuvirtide through 48 Weeks in the TORO Trials.
43rd Interscience Conference on Antimicrobial Agents and Chemotherapy,
[181.]
J. Montaner, D. Guimaraes, J. Chung, Z. Gafoor, M. Salgo, R. DeMasi.
Prognostic staging of extensively pretreated patients with advanced HIV-1 disease.
HIV Clin Trials, 6 (2005), pp. 281-290
[182.]
F. Raffi, C. Katlama, M. Saag, M. Wilkinson, J. Chung, L. Smiley, et al.
Week-12 response to therapy as a predictor of week 24, 48, and 96 outcome in patients receiving the HIV fusion inhibitor enfuvirtide in the T-20 versus Optimized Regimen Only (TORO) trials.
Clin Infect Dis, 42 (2006), pp. 870-877
[183.]
E. Dailly, M.C. Gagnieu, C. Allavena, F. Raffi, P. Jolliet.
No significant influence of saquinavir hard-gel capsule administration on pharmacokinetics of lopinavir in combination with ritonavir: a population approach.
Ther Drug Monit, 27 (2005), pp. 782-784
[184.]
E. Ribera, R.M. López, M. Díaz, L. Pou, L. Ruiz, V. Falco, et al.
Steady-state pharmacokinetics of a double-boosting regimen of saquinavir soft gel plus lopinavir plus minidose ritonavir in human immunodeficiency virus-infected adults.
Antimicrob Agents Chemother, 48 (2004), pp. 4256-4262
[185.]
H. Khanlou, E. Graham, M. Brill, C. Farthing.
Drug interaction between amprenavir and lopinavir/ritonavir in salvage therapy.
AIDS, 16 (2002), pp. 797-798
[186.]
A.D. Kashuba, C. Tierney, G.F. Downey, E.P. Acosta, E.N. Vergis, K. Klingman, et al.
Combining fosamprenavir with lopinavir/ritonavir substantially reduces amprenavir and lopinavir exposure: ACTG protocol A5143 results.
AIDS, 19 (2005), pp. 145-152
[187.]
E. Ribera, C. Azuaje, R.M. López, M. Díaz, M. Feijoo, L. Pou, et al.
Atazanavir and lopinavir/ritonavir: pharmacokinetics, safety and efficacy of a promising double-boosted protease inhibitor regimen.
AIDS, 20 (2006), pp. 1131-1139
[188.]
S.G. Deeks, J.D. Barbour, J.N. Martin, M.S. Swanson, R.M. Grant.
Sustained CD4+ T cell response after virologic failure of protease inhibitor-based regimens in patients with human immunodeficiency virus infection.
J Infect Dis, 181 (2000), pp. 946-953
[189.]
S. Grabar, V. Le Moing, C. Goujard, C. Leport, M.D. Kazatchkine, D. Costagliola, et al.
Clinical outcome of patients with HIV < -1 infection according to immunologic and virologic response after 6 months of highly active antiretroviral therapy.
Ann Intern Med, 133 (2000), pp. 401-410
[190.]
S.G. Deeks, J.D. Barbour, R.M. Grant, J.N. Martín.
Duration and predictors of CD4 T-cell gains in patients who continue combination therapy despite detectable plasma viremia.
AIDS, 16 (2002), pp. 201-207
[191.]
S.G. Deeks, J.N. Martín.
Reassessing the goal of antiretroviral therapy in the heavily pre-treated HIV-infected patient.
AIDS, 15 (2001), pp. 117-119
[193.]
A.M. Anderson, J.A. Bartlett.
Changing antiretroviral therapy in the setting of virologic relapse: review of the current literature.
Curr HIV/AIDS Rep, 3 (2006), pp. 79-85
[194.]
E. Ribera, K. Aguirrebengoa, C. Miralles, A. Antela, A. Rivero, J.R. Arribas.
Simplificación del tratamiento antiretroviral.
Enferm Infecc Microbiol Clin, 20 (2002), pp. 48-57
[195.]
D.V. Havlir, I.C. Marschner, M.S. Hirsch, A.C. Collier, P. Tebas, R.L. Bassett, et al.
Maintenance antiretroviral therapies in HIV infected patients with undetectable plasma HIV RNA after triple-drug therapy. AIDS Clinical Trials Group Study 343 Team.
N Engl J Med, 339 (1998), pp. 1261-1268
[196.]
M.H. Reijers, G.J. Weverling, S. Jurriaans, F.W. Wit, H.M. Weigel, R.W. Ten Kate, et al.
Maintenance therapy after quadruple induction therapy in HIV-1 infected individuals: Amsterdam Duration of Antiretroviral Medication (ADAM) study.
Lancet, 352 (1998), pp. 185-190
[197.]
P. Flandre, F. Raffi, D. Descamps, V. Calvez, G. Peytavin, V. Meiffredy, et al.
Final analysis of the Trilege induction-maintenance trial: results at 18 months.
AIDS, 16 (2002), pp. 561-568
[198.]
D.A. Cooper, S. Emery.
Therapeutic strategies for HIV infection-time to think hard.
N Engl J Med, 339 (1998), pp. 1319-1321
[199.]
J.R. Arribas, F. Pulido, R. Delgado, A. Lorenzo, P. Miralles, A. Arranz, et al.
Lopinavir/ ritonavir as single-drug therapy for maintenance of HIV-1 viral suppression: 48-week results of a randomized, controlled, open-label, proof-of-concept pilot clinical trial (OK Study).
J Acquir Immune Defic Syndr, 40 (2005), pp. 280-287
[200.]
J. Arribas, F. Pulido, R. Delgado, E. Cabrero, C. Cepeda, J. González-García, et al.
Lopinavir/ritonavir as single-drug maintenance therapy in patients with HIV-1 viral suppression: Forty eight week results of a randomized, controlled, open label, clinical trial (OK04 Study).
XVI International AIDS Conference,
[201.]
S. Swindells, A.G. DiRienzo, T. Wilkin, C.V. Fletcher, D.M. Margolis, G.D. Thal, et al.
Regimen simplification to atazanavir-ritonavir alone as maintenance antiretroviral therapy after sustained virologic suppression.
JAMA, 296 (2006), pp. 806-814
[202.]
E. Martínez, J.A. Arnaiz, D. Podzamczer, D. Dalmau, E. Ribera, P. Domingo, et al.
Substitution of nevirapine, efavirenz, or abacavir for protease inhibitors in patients with human immunodeficiency virus infection.
N Engl J Med, 349 (2003), pp. 1036-1046
[203.]
J.M. Gatell, D. Salmon-Ceron, A. Lalezzari, E. Van Wijngaerden, F. Antunes, C. Leen, et al.
Efficacy and safety of atazanavir based HAART in patients switching from a stable boosted/unboosted protease inhibitor treatment: the SWAN Study.
10th European AIDS Conference,
Copyright © 2007. Elsevier España S.L.. Todos los derechos reservados
