Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults

作者：Rajesh T. Gandhi, Roger Bedimo, Jennifer Hoy, Raphael J. Landovitz, Davey M. Smith, Ellen Eaton, Clara Lehmann, Sandra A. Springer, Paul E. Sax, Melanie Thompson, Constance A. Benson, Susan Buchbinder, Carlos del Rı́o, Joseph J. Eron, Huldrych F. Günthard, Jean‐Michel Molina, Donna M. Jacobsen, Michael S. Saag · 发表于：JAMA · 年份：2022 · DOI：10.1001/jama.2022.22246 · 被引用次数：558 · 研究领域：HIV/AIDS Research and Interventions、HIV-related health complications and treatments、HIV/AIDS drug development and treatment

Importance: Recent advances in treatment and prevention of HIV warrant updated recommendations to guide optimal practice. Objective: Based on a critical evaluation of new data, to provide clinicians with recommendations on use of antiretroviral drugs for the treatment and prevention of HIV, laboratory monitoring, care of people aging with HIV, substance use disorder and HIV, and new challenges in people with HIV, including COVID-19 and monkeypox virus infection. Evidence Review: A panel of volunteer expert physician scientists were appointed to update the 2020 consensus recommendations. Relevant evidence in the literature (PubMed and Embase searches, which initially yielded 7891 unique citations, of which 834 were considered relevant) and studies presented at peer-reviewed scientific conferences between January 2020 and October 2022 were considered. Findings: Initiation of antiretroviral therapy (ART) is recommended as soon as possible after diagnosis of HIV. Barriers to care should be addressed, including ensuring access to ART and adherence support. Integrase strand transfer inhibitor-containing regimens remain the mainstay of initial therapy. For people who have achieved viral suppression with a daily oral regimen, long-acting injectable therapy with cabotegravir plus rilpivirine given as infrequently as every 2 months is now an option. Weight gain and metabolic complications have been linked to certain antiretroviral medications; novel strategies to ameliorate these compl...