Publication: Rilpivirina o Raltegravir más Abacavir/Lamivudina como estrategias de Switching en pacientes con infección VIH-1 y supresión virológica
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2018-11-29
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Universidad Complutense de Madrid
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Abstract
Desde la introducción de la triple triple terapia en año 1996, el paradigma de la infección por el virus de la inmunodeficiencia humana adquirida (VIH) se ha modificado con la cronificación de la misma y con ello una disminución significativa de la morbi-mortalidad. El espectro de fármacos usados desde entonces ha cambiado considerablemente con la aparición de moléculas máspotentes y seguras, nuevas familias de fármacos dirigidos a nuevas dianasterapéuticas y la optimización y simplificación de los mismos mediantecombinaciones fijas más cómodas para el paciente. Todo ello ha llevado a alcanzar elevadas tasas de respuesta virológica en pacientes naïve (sin tratamiento previo), en muchos casos superiores al 90%. No obstante, el uso de los antirretrovirales actuales, no está exento de algunos problemas de toxicidad/tolerabilidad (ósea, renal o neuro psiquiátrica entre otras), que pueden suponer un menoscabo de la adherencia del paciente a dichos tratamientos y favorecer con ello el desarrollo de fracasos virológicos...
Since the introduction of triple therapy in 1996, the paradigm of HIV infection hasbeen modified with the chronification of HIV and consequently with a significantdecrease in morbidity and mortality. The spectrum of drugs used since then haschanged considerably with the generation of more potent and safe molecules,new families of drugs directed to new therapeutic targets and the optimizationand simplification of part of them, through more comfortable fixed combinations.This new situation has led to high rates of virological response in naïve patients,in many cases greater than 90%. However, the use of current antiretrovirals issometimes associated with toxicity/tolerability problems (bone, renal,neuropsychiatric ...), which may lead to impairment of patient's adherence tocART (combination of antiretroviral therapy) and predisposes to virologicalfailure...
Since the introduction of triple therapy in 1996, the paradigm of HIV infection hasbeen modified with the chronification of HIV and consequently with a significantdecrease in morbidity and mortality. The spectrum of drugs used since then haschanged considerably with the generation of more potent and safe molecules,new families of drugs directed to new therapeutic targets and the optimizationand simplification of part of them, through more comfortable fixed combinations.This new situation has led to high rates of virological response in naïve patients,in many cases greater than 90%. However, the use of current antiretrovirals issometimes associated with toxicity/tolerability problems (bone, renal,neuropsychiatric ...), which may lead to impairment of patient's adherence tocART (combination of antiretroviral therapy) and predisposes to virologicalfailure...
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Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 19-03-2018