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Current approach to antiretroviral therapy

Publication at First Faculty of Medicine |
2020

Abstract

Antiretroviral therapy is a basis for HIV (human immunodeficiency virus) treatment of positive people. Antiretroviral drugs are divided into six groups according to the mechanism of action and chemical structure.

Some block the function of three viral enzymes and other block the viral entry into the cell. In most patients, a suppression of viral replication is reached that is a pre-requisite for the return and maintenance of sufficient immune system function.

The treatment is also important for reducing the risk of HIV infection transfer to other people. Although the treatment prevents classic medical complications of HIV infection associated with immunodeficiency, it does not prevent completely the activation of immune system and the risk of non-AIDS complications.

The usual initial combination of antiretroviral drugs includes two nucleoside or rather one nucleoside and one nucleotide inhibitor of reverse transcriptase together with integrase inhibitor. In certain circumstances, the use of for example the new non-nucleoside inhibitors of reverse transcriptase or protease inhibitors is warranted.

Alongside this conventional therapy, the use of dual combination regimens based on the reliability of dolutegravir is slowly asserted. The promise of the decrease of toxicity, drug interactions and cost while maintaining efficacy comes with these regimens.

Certain theoretical obstacles are not out of the question and the benefit can be expected in selected groups of patients.