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antiretroviral therapy (ART)

Indications: - treatment of retroviral infection - treatment of HIV infection - especially treatment of HIV1 & AIDS Procedure: - treatment with antiretroviral agent(s) Notes: - 3 drugs from 2 different classes - 2 nucleoside reverse transcriptase inhibitors - integrase inhibitor [9] - antiretroviral therapy with 3TC, tenofovir, or both, reduces risk for hepatitis B virus infection ~90% compared with other or no antiretroviral therapy [5] - all-cause mortality in the 1st year declined from 2000-2003 to 2008-2010 (RR=0.71) [7] - many HIV patients on antiretroviral therapy will not have viral rebound in their lifetimes [8] - viral rebound rate 1.0% per year for homosexual men > 45 years of age after 7 years of antiretroviral therapy [8]

Related

antiretroviral agent

Specific

highly active antiretroviral therapy (HAART)

General

pharmacology

References

  1. The Antiretroviral Therapy (ART) Cohort Collaboration. HIV treatment response and prognosis in Europe and North America in the first decade of highly active retroviral therapy. A collaborative analysis. Lancet 2006, 36:451 PMID: 1689083
  2. Yilmaz A et al, Cerebrospinal fluid viral loads reach less than 2 copies/mL in HIV-1 infected patients with effective antiretroviral therapy. Antivir Ther 2006, 11:833 - Spudich S et al, Treatment benefit on cerebrospinal fluid HIV-1 levels in the settings of systmeic virological suppression and failure. J Infect Dis 2006, 194:1686 PMID: 17109340
  3. Bartlett JA et al, An updated systematic overview of triple combination therapy in antiretroviral-naive HIV-infected adults. AIDS 2006, 20:2051 PMID: 17053351
  4. Goetz MB Recommendations for Initiating Antiretroviral Therapy Reflect Return to Earlier Treatment Methods http://guideline.gov/expert/expert-commentary.aspx?f=rss&id=37872
  5. Gatanaga H et al. Prophylactic effect of antiretroviral therapy on hepatitis B virus infection. Clin Infect Dis 2013 Jun 15; 56:1812. PMID: 23487374
  6. Greig J, Casas EC, O'Brien DP, Mills EJ, Ford N. Association between older age and adverse outcomes on antiretroviral therapy: a cohort analysis of programme data from nine countries. AIDS. 2012 Jul 31;26 Suppl 1:S31-7. PMID: 22781173
  7. The Antiretroviral Therapy Cohort Collaboration Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies. The Lancet. HIV. 10 May 2017 http://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext
  8. O'Connor J et al. Durability of viral suppression with first-line antiretroviral therapy in patients with HIV in the UK: An observational cohort study. Lancet HIV 2017 May 4; PMID: 28479492 Free Article http://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30053-X/fulltext
  9. Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018