Der Hautarzt

, Volume 57, Issue 11, pp 961–968

Antiretrovirale Therapieregime

Leitthema

Zusammenfassung

Die Verfügbarkeit und Anwendung von wirksamen antiretroviralen Therapieregimen haben die Mortalität und Morbidität der HIV-Infektion dramatisch gesenkt. Die weitestgehende Hemmung der Virusreplikation durch eine antiretrovirale Therapie (ART) verhindert die Krankheitsprogression sowie die Resistenzentwicklung, führt zur Rückbildung HIV-bedingter Symptome und zur klinisch relevanten Immunrekonstitution. Mittlerweile sind über 20 antiretrovirale Substanzen in 4 Medikamentenklassen zugelassen. Die Infektion ist dadurch besser behandelbar, die ART ist jedoch schwieriger geworden. Eine Vielzahl von Kombinationen ist denkbar, von denen nur eine kleine Zahl sinnvoll ist. Indikationsstellung, Auswahl der individuell am besten geeigneten Therapie, Beratung des Patienten und Therapiemonitoring erfordern ein hohes Maß an Erfahrung im Umgang mit HIV-infizierten Patienten. Unter den modernen Therapieregimen wird beim adhärenten Patienten nur noch selten ein virologisches Versagen beobachtet.

Schlüsselwörter

HIV-Infektion Antiretrovirale Therapie Initialtherapie Therapieversagen Antiretrovirale Substanzen 

Antiviral treatment regimens

Abstract

The availability and use of effective antiretroviral combination therapies has dramatically decreased the morbidity and mortality of HIV infection. Almost complete suppression of viral replication by antiretroviral therapy prevents disease progression and development of resistance, as well as leading to both regression of HIV-associated symptoms and clinically relevant immune reconstitution. More than 20 antiretroviral substances in four classes have been approved. As a result of the broad therapeutic options, HIV infection can be better treated. Although a high number of combinations can be conceived, only a small number is actually applicable. The decisions to start, monitor and change therapy have become even more difficult. The indication for treatment, the selection of the most suitable therapy for an individual, the counseling of the patient, and the monitoring of the success of treatment demand a high level of knowledge and experience. Virologic failures of modern antiretroviral therapy regimens are rare in adherent patients.

Keywords

HIV infection Antiretroviral therapy Initial therapeutic regimen Virologic failure Antiretroviral agents 

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Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  1. 1.Klinik für Dermatologie, Venerologie und AllergologieUniversitätsklinikum EssenEssen

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