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highly active antiretroviral therapy (HAART)
Combinations of antiretroviral agents used in treatment of HIV1.
Indications:
- retroviral infection
- HIV infection
- HIV1 infection
- HIV infection during pregnancy is always an indication for HAART
- race NOT a factor in treatment outcomes [2]
Dosage:
1) one antiretroviral protease inhibitor + 2 NRTI
2) one NNRTI plus 2 NRTI
3) three NRTIs
4) two antiretroviral protease inhibitors + 2 NRTI [4]
zidovudine should be incorporated in all HAART regimens
do NOT use stavudine since combination of zidovudine & stavudine is contraindicated
high-dose multivitamin not helpful, perhaps harmful [5]
Adverse effects:
1) HAART may not be associated with better outcomes [1]
2) immune reconstitution inflammatory syndrome
3) paradoxical worsening of underlying opportunistic infection
4) increased risk of cardiovascular disease [4]
Related
antiretroviral agent
General
antiretroviral therapy (ART)
References
- 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: 16890831
- Silverberg MJ et al,
Effectiveness of highly-active antiretroviral therapy by
therapy by race/ethnicity. AIDS 2006, 20:1431
PMID: 16847408
- Sackoff JE et al,
Causes of death among persons with AIDS in the era of highly
active antiretroviral therapy: New York City
Ann Intern Med 2006, 145:397
PMID: 16983127
- Aberg JA
The changing face of HIV care: Common things really are common.
Ann Intern Med 2006, 145:463
PMID: 16983135
- Medical Knowledge Self Assessment Program (MKSAP) 14, 15
American College of Physicians, Philadelphia 2006, 2009
- Isanaka S et al
Effect of High-Dose vs Standard-Dose Multivitamin
Supplementation at the Initiation of HAART on HIV Disease
Progression and Mortality in Tanzania
A Randomized Controlled Trial
JAMA. 2012;308(15):1535-1544.
PMID: 23073950
http://jama.jamanetwork.com/article.aspx?articleid=1383231