aidsВИЧ-инфекция и иммуносупрессииHIV Infection and Immunosuppressive Disorders2077-9828Baltic Medical Education Center10.22328/2077-9828-2017-9-2-27-35aids-256Research ArticleАНАЛИТИЧЕСКИЙ ОБЗОРANALYTICAL REVIEWАНТИРЕТРОВИРУСНАЯ ТЕРАПИЯ ВИЧ-ИНФЕКЦИИ: ПЕРСПЕКТИВЫ УПРОЩЕНИЯ СХЕМANTIRETROVIRAL THERAPY FOR HIV INFECTION: PROSPECTS FOR SIMPLIFIED THERAPEUTIC REGIMENSМатиевскаяН. В.MatiyevskayaN. V.

Матиевская Наталья Васильевна — доктор математических наук, доцент, зав. кафедрой инфекционных болезней УO «Гродненский государственный медицинский университет».

230009, Гродно, ул. Горького, 80.  

natamati@mail.ruУО «Гродненский государственный медицинский университет».БеларусьGrodno State Medical UniversityBelarus201707072017922735Copyright © Матиевская Н.В., 20172017Матиевская Н.В.Matiyevskaya N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hiv.bmoc-spb.ru/jour/article/view/256

Представлен обзор научной литературы по современным подходам к проведению антиретровирусной терапии пациентам, инфицированным вирусом иммунодефицита человека, контролю резистентности вируса к антиретровирусным препаратам, вирусологическому обоснованию, клиническим показаниям и результатам исследований по оценке эффективности упрощенных схем антиретровирусной терапии в виде монотерапии или комбинации двух антиретровирусных препаратов. Вирусологическая супрессия вируса иммунодефицита человека (вирусная нагрузка менее 50 копий/мл) является наиболее важным критерием эффективности антиретровирусной терапии, позволяет предотвратить формирование резистентности вируса к антиретровирусным препаратам. Перевод пациентов на упрощенные схемы антиретровирусной терапии позволяет уменьшить частоту нежелательных явлений и взаимодействий антиретровирусных препаратов, повысить приверженность к терапии, снизить стоимость лечения. Внедрение упрощенных схем терапии в клиническую практику возможно при использовании препаратов с высоким генетическим барьером к резистентности у тщательно отобранных пациентов, достигших вирусологической супрессии вируса иммунодефицита человека на стандартных трехкомпонентных схемах, не имевших в прошлом тяжелой иммуносупрессии (CD4+ T-лимфоциты <200 кл/мкл), с высокой приверженностью к терапии, находящихся под тщательным вирусологическим мониторингом.

Literature on current approaches to ART for HIV; control of HIV resistance to ART; and virologic and clinical criteria for ART and on the evaluation of ART regimens limited to monotherapy or the use of two ART drugs is reviewed. Viral load below 50 RNA copies per 1 mL is the most important criterion of ART efficacy and provides for preventing HIV resistance to ART. Simplified ART regimens make it possible to reduce adverse events and drug interactions; to enhance adherence to therapy; and to decrease the cost of ART. Such regimens are applicable to patients who show viral load suppression below 50 mL–1 upon standard three-component ART regimens; never had severe immunosuppression (CD4 T-cell counts below 200 mL–1); are highly adherent to therapy; and are under strict virological monitoring.

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The authors declare that there are no conflicts of interest present.