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La terapia antirretroviral y el manejo de la infección por VIH

Paul A Volberding¹, Steven G Deeks

¹Department of Medicine, University of California San Francisco, San Francisco, CA 94121, USA. paul.volberding@va.gov

Lancet (London, England)

|July 9, 2010

Resumen

La terapia antirretroviral (TAR) ha transformado el VIH de mortal a crónico. Sin embargo, la adherencia de por vida es crucial, y la TAR puede causar efectos tóxicos y complicaciones no relacionadas con el SIDA.

Área de la Ciencia:

Enfermedades infecciosas Enfermedades infecciosas.
Virología Virología.
Inmunología Inmunología.

Sus antecedentes:

La terapia antirretroviral (TAR) ha mejorado dramáticamente los resultados de la infección por VIH, cambiándola de una enfermedad mortal a una condición crónica manejable.
La disponibilidad de 17 fármacos permite terapias combinadas que pueden lograr una supresión duradera de la replicación del VIH.

Objetivo del estudio:

Revisar los éxitos y las limitaciones persistentes de la terapia antirretroviral actual para la infección por VIH.
Para resaltar los desafíos en curso en el manejo del VIH, incluyendo la adherencia, la toxicidad, el costo y las complicaciones de salud a largo plazo.

Principales métodos:

Revisión de la literatura sobre el tratamiento antirretroviral para el VIH.
Análisis de la eficacia del tratamiento, los requisitos de adherencia y las toxicidades relacionadas con el medicamento.
Examen de los factores económicos y las comorbilidades no relacionadas con el SIDA en los pacientes tratados.

Principales resultados:

ART puede conducir a la supresión de por vida de la replicación del VIH con la adherencia.
Las limitaciones incluyen la necesidad de una adhesión estricta de por vida, toxicidades a corto y largo plazo de los medicamentos y costos significativos.
La supresión viral efectiva no restaura completamente la salud, con una disfunción inmune persistente y un mayor riesgo de complicaciones no relacionadas con el SIDA.

Conclusiones:

Si bien el ART es muy exitoso, los desafíos permanecen en su aplicación a largo plazo.
Abordar la adherencia, manejar las toxicidades, reducir los costos y mitigar las complicaciones no relacionadas con el SIDA son fundamentales para mejorar la calidad de vida de las personas con VIH.

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