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El fin del SIDA: la infección por el VIH como enfermedad crónica

Steven G Deeks¹, Sharon R Lewin, Diane V Havlir

¹Department of Medicine, University of California, San Francisco, CA, USA.

Lancet (London, England)

|October 25, 2013

Resumen

La terapia antirretroviral transformó el SIDA en una enfermedad crónica por VIH. El tratamiento a largo plazo causa nuevas complicaciones, aumentando la necesidad de una cura para el VIH.

Área de la Ciencia:

Enfermedades infecciosas Enfermedades infecciosas.
Inmunología Inmunología.
Salud Pública La salud pública.

Sus antecedentes:

La terapia antirretroviral (TAR) ha mejorado significativamente los resultados para las personas con VIH/SIDA.
ART ha cambiado el paradigma de una enfermedad terminal a una condición crónica de por vida.
A pesar del éxito de la terapia antirretroviral, el VIH sigue siendo una enfermedad crónica compleja con complicaciones emergentes.

Objetivo del estudio:

Examinar las consecuencias a largo plazo para la salud de vivir con el VIH bajo un tratamiento eficaz.
Para resaltar los desafíos en evolución en el manejo del VIH como una enfermedad crónica.
Para subrayar la creciente importancia de abordar las complicaciones asociadas con el VIH y la búsqueda de una cura.

Principales métodos:

Este estudio es una revisión narrativa de la literatura actual sobre el manejo del VIH y los resultados a largo plazo.
Análisis de datos sobre complicaciones asociadas al VIH, incluidas enfermedades cardiovasculares, cáncer y trastornos metabólicos.
Examen del impacto de la toxicidad acumulada de los medicamentos antirretrovirales durante décadas.

Principales resultados:

El VIH es ahora una enfermedad crónica para los pacientes con acceso a ART de por vida, y las enfermedades relacionadas con el SIDA ya no son la principal amenaza.
Las nuevas complicaciones como las enfermedades cardiovasculares y el cáncer están aumentando debido a la restauración inmune incompleta y la inflamación.
El uso a largo plazo de TAR lleva a efectos tóxicos acumulativos, causando trastornos metabólicos y daños en los órganos terminales.

Conclusiones:

El manejo del VIH se ha convertido en una enfermedad crónica de por vida que requiere atención continua.
La creciente carga de comorbilidades asociadas al VIH plantea desafíos para el envejecimiento saludable y los sistemas de atención médica, especialmente en entornos con recursos limitados.
Un esfuerzo global para encontrar una cura para el VIH es crucial dada la complejidad de la gestión a largo plazo y el potencial de abrumadores sistemas de salud.

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