العلاج الخط الأول لمتلازمة نقص المناعة المكتسب

References

• The Panel on Antiretroviral Guidelines for Adults and Adolescents (the Panel) now recommends initial ARV regimens based on an oral second-generation INSTI plus two NRTIs—bictegravir (BIC)/tenofovir alafenamide (TAF)/emtricitabine (FTC) (AI) or dolutegravir (DTG) plus TAF/FTC or tenofovir disoproxil fumarate (TDF)/FTC or TDF/lamivudine (3TC) (AI)—for most people with HIV.
• In some people with HIV, the two-drug regimen DTG/3TC can be used (AI).
• DTG/3TC (AI), except for individuals with HIV RNA >500,000 copies/mL, HBV coinfection, or in whom ART is to be started before the results of HIV genotypic resistance testing for reverse transcriptase or HBV testing are available.
• Individuals who are adherent to their ARV regimens and do not harbor resistance mutations to the component drugs can generally achieve viral suppression 8 to 12 weeks after ART initiation or after modification due to virologic failure; rarely, it may take longer in some people.
• For most people, an adequate response is defined as an increase in CD4 count in the range of 50 cells/mm3 to 150 cells/mm3 in the first year of ART, generally with an accelerated response in the first 3 months of treatment.