Redefining therapeutic success in HIV patients: an expert view

Author:

Antela Antonio1,Rivero Antonio23,Llibre Josep M4,Moreno Santiago5,Antela Antonio,Llibre Josep M,Moreno Santiago,Rivero Antonio,Alonso Montero Marta,Bernal Enrique,Ramos José Ramón Blanco,Castaño Manuel,Dalmau Juanola David,de la Fuente García Belén,Dueñas Carlos,Espinosa Nuria,Estrada Vicente,José Galindo Puerto María,García del Toro Miguel,González Juan,Górgolas Miguel,Hidalgo-Tenorio Carmen,Knobel Freu Hernando,Carlos López Bernaldo de Quirós Juan,Macías Sánchez Juan,Martín Ruíz Carlos,Martínez Chamorro Esteban,Masía Mar,Miguelez Máximo,Miralles Celia,Olalla Julián,Pascuet Esteban Ribera,Rodríguez-Vidigal Francisco,Rubio Rafael,Jesús Santos,

Affiliation:

1. Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain

2. Hospital Universitario Reina Sofía, Cordoba, Spain

3. Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain

4. Hospital Universitari Germans Trias i Pujol, Badalona, Spain

5. Hospital Universitario Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain

Abstract

Abstract Thanks to advances in the field over the years, HIV/AIDS has now become a manageable chronic condition. Nevertheless, a new set of HIV-associated complications has emerged, related in part to the accelerated ageing observed in people living with HIV/AIDS, the cumulative toxicities from exposure to antiretroviral drugs over decades and emerging comorbidities. As a result, HIV/AIDS can still have a negative impact on patients’ quality of life (QoL). In this scenario, it is reasonable to believe that the concept of therapeutic success, traditionally associated with CD4 cell count restoration and HIV RNA plasma viral load suppression and the absence of drug resistances, needs to be redefined to include other factors that reach beyond antiretroviral efficacy. With this in mind, a group of experts initiated and coordinated the RET Project, and this group, using the available evidence and their clinical experience in the field, has proposed new criteria to redefine treatment success in HIV, arranged into five main concepts: rapid initiation, efficacy, simplicity, safety, and QoL. An extensive review of the literature was performed for each category, and results were discussed by a total of 32 clinicians with experience in HIV/AIDS (4 coordinators + 28 additional experts). This article summarizes the conclusions of these experts and presents the most updated overview on the five topics, along with a discussion of the experts’ main concerns, conclusions and/or recommendations on the most controversial issues.

Funder

Gilead Sciences

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology,Microbiology (medical)

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