Challenges in Initiating Antiretroviral Therapy in 2010
Many clinical trials have shown that initiating antiretroviral therapy (ART) at higher rather than lower CD4 T cell-positive counts results in survival benefit. Early treatment can help prevent end-organ damage associated with HIV replication and can decrease infectivity. The mainstay of treatment i...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2010-01-01
|
| Series: | Canadian Journal of Infectious Diseases and Medical Microbiology |
| Online Access: | http://dx.doi.org/10.1155/2010/834627 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832554124649955328 |
|---|---|
| author | Cécile L Tremblay Jean-Guy Baril David Fletcher Donald Kilby Paul MacPherson Stephen D Shafran Mark W Tyndall |
| author_facet | Cécile L Tremblay Jean-Guy Baril David Fletcher Donald Kilby Paul MacPherson Stephen D Shafran Mark W Tyndall |
| author_sort | Cécile L Tremblay |
| collection | DOAJ |
| description | Many clinical trials have shown that initiating antiretroviral therapy (ART) at higher rather than lower CD4 T cell-positive counts results in survival benefit. Early treatment can help prevent end-organ damage associated with HIV replication and can decrease infectivity. The mainstay of treatment is either a non-nucleoside reverse transcriptase inhibitor or a ritonavir-boosted protease inhibitor in combination with two nucleoside reverse transcriptase inhibitors. While effective at combating HIV, ART can produce adverse alterations of lipid parameters, with some studies suggesting a relationship between some anti-retroviral agents and cardiovascular disease. As the HIV-positive population ages, issues such as hypertension and diabetes must be taken into account when initiating ART. Adhering to ART can be difficult; however, nonoptimal adherence to ART can result in the development of resistance; thus, drug characteristics and the patient’s preparedness to begin therapy must be considered. Reducing the pill burden through the use of fixed-dose antiretroviral drug combinations can facilitate adherence. |
| format | Article |
| id | doaj-art-ef63a68815ee4c04b3442b4b3df5dfe1 |
| institution | Kabale University |
| issn | 1712-9532 |
| language | English |
| publishDate | 2010-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Infectious Diseases and Medical Microbiology |
| spelling | doaj-art-ef63a68815ee4c04b3442b4b3df5dfe12025-02-03T05:52:22ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95322010-01-0121Suppl C1C15C10.1155/2010/834627Challenges in Initiating Antiretroviral Therapy in 2010Cécile L Tremblay0Jean-Guy Baril1David Fletcher2Donald Kilby3Paul MacPherson4Stephen D Shafran5Mark W Tyndall6Division of Infectious Diseases, Centre Hospitalier de L’Université de Montréal-Hotel Dieu, CanadaClinique du Quartier Latin and Centre Hospitalier de l’Université de Montréal, Montréal, Québec, CanadaMaple Leaf Medical Clinic, Toronto, CanadaUniversity of Ottawa, CanadaOttawa Health Research Institute; Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Division of Infectious Diseases, Ottawa Hospital General Campus, Ottawa, Ontario, CanadaDivision of Infectious Diseases, University of Alberta, Edmonton, Alberta, CanadaDivision of Infectious Diseases, University of British Columbia, BC Centre for Excellence in HIV/AIDS, St Paul’s Hospital, Vancouver, British Columbia, CanadaMany clinical trials have shown that initiating antiretroviral therapy (ART) at higher rather than lower CD4 T cell-positive counts results in survival benefit. Early treatment can help prevent end-organ damage associated with HIV replication and can decrease infectivity. The mainstay of treatment is either a non-nucleoside reverse transcriptase inhibitor or a ritonavir-boosted protease inhibitor in combination with two nucleoside reverse transcriptase inhibitors. While effective at combating HIV, ART can produce adverse alterations of lipid parameters, with some studies suggesting a relationship between some anti-retroviral agents and cardiovascular disease. As the HIV-positive population ages, issues such as hypertension and diabetes must be taken into account when initiating ART. Adhering to ART can be difficult; however, nonoptimal adherence to ART can result in the development of resistance; thus, drug characteristics and the patient’s preparedness to begin therapy must be considered. Reducing the pill burden through the use of fixed-dose antiretroviral drug combinations can facilitate adherence.http://dx.doi.org/10.1155/2010/834627 |
| spellingShingle | Cécile L Tremblay Jean-Guy Baril David Fletcher Donald Kilby Paul MacPherson Stephen D Shafran Mark W Tyndall Challenges in Initiating Antiretroviral Therapy in 2010 Canadian Journal of Infectious Diseases and Medical Microbiology |
| title | Challenges in Initiating Antiretroviral Therapy in 2010 |
| title_full | Challenges in Initiating Antiretroviral Therapy in 2010 |
| title_fullStr | Challenges in Initiating Antiretroviral Therapy in 2010 |
| title_full_unstemmed | Challenges in Initiating Antiretroviral Therapy in 2010 |
| title_short | Challenges in Initiating Antiretroviral Therapy in 2010 |
| title_sort | challenges in initiating antiretroviral therapy in 2010 |
| url | http://dx.doi.org/10.1155/2010/834627 |
| work_keys_str_mv | AT cecileltremblay challengesininitiatingantiretroviraltherapyin2010 AT jeanguybaril challengesininitiatingantiretroviraltherapyin2010 AT davidfletcher challengesininitiatingantiretroviraltherapyin2010 AT donaldkilby challengesininitiatingantiretroviraltherapyin2010 AT paulmacpherson challengesininitiatingantiretroviraltherapyin2010 AT stephendshafran challengesininitiatingantiretroviraltherapyin2010 AT markwtyndall challengesininitiatingantiretroviraltherapyin2010 |