美国2014年版艾滋病抗病毒治疗指南主要更新内容解读

Interpretation of the major updates in 2014 DHHS guidelines for the use of antiretroviral therapy in HIV-1-infected adults and adolescents

美国卫生与公共服务部于2014年5月发布了新版成人及青少年艾滋病抗病毒治疗指南。与2013年2月发布的指南相比,新版指南主要对以下内容进行了更新:改变了在初始抗病毒治疗后随访CD4+T淋巴细胞计数的频率的建议;在初始抗病毒治疗的"推荐方案"中增加了3种含有整合酶链转移抑制剂的治疗方案;阐述了在艾滋病病毒活性被充分抑制的情况下更换抗病毒治疗方案所应遵循的基本原则;在"抗病毒药物的副作用"部分增加了一个表格,对常用抗病毒药物的毒、副作用进行了归纳总结,并就可以使用何种替代药物给临床医师提供了指导意见。

The guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents were released by the Department of Health and Human Services, USA in May, 2014. As compared with the ones issued in February, 2013, the key updates include： revised the recommendations on frequency of CD4^＋ count monitoring after initial antiretroviral therapy （ART）, listed more options to the recommended regimens for initial ART of naive AIDS patients, removed several ART drugs that are less effective, less convenient, and/or more toxic than current options from the recommended regimens, emphasized the key principles which need to be followed when considering to switch the ART drugs while the viral load has been suppressed and added a new table that summarizes the adverse effects of current ART drugs and provided recommendations for choosing alternative ART drugs.