Educative work ACTA.FAC.MED.NAISS. 1998; 16(2), 89-93

THE CURRENT CONCEPT OF ANTIRET

Doc. dr Đorde Jevtović

In the past several years a better understanding of HIV pathogenesis has led to the development of new concepts such as early therapeutic intervention using combination antiviral therapy. It has proven the most effective approach to treat HIV disease. The profound and sustained viral supression achiavable with combination of nucleoside and non-nucleoside inhibitors of reverse transcriptase and protease inhibitors has resultated in dramatic improvement in immune sistem functioning along with the clinical signs of immune reconstitution such as the decrease of the incidence of opportunistic events in those already immunosuppressed patients. When introduced very early in the course of HIV infection combination therapy is even alowing a HIV-specific CD4-mediated immune response to be preserved in a subgroup of patients. However resistance has been described to all classes of antiretroviral drugs used until now and combination therapy can also result in pharmacologic antagonism and unexpected toxicites, which may all compromise the treatment protocols. This is why the definition and the management of adverse events and treatment failure still need to be better defined.

Key words: HIV, combination therapy