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Enhancing care for people living with HIV: current and future monitoring approaches
Expert Review of Anti-infective Therapy ( IF 5.7 ) Pub Date : 2020-10-15 , DOI: 10.1080/14787210.2021.1823217
Franco Maggiolo 1 , Alessandra Bandera 2 , Stefano Bonora 3 , Marco Borderi 4 , Andrea Calcagno 3 , Annamaria Cattelan 5 , Antonella Cingolani 6 , Nicola Gianotti 7 , Miriam Lichtner 8 , Sergio Lo Caputo 9 , Giordano Madeddu 10 , Paolo Maggi 11 , Giulia Carla Marchetti 12 , Renato Maserati 13 , Silvia Nozza 7 , Stefano Rusconi 14 , Maurizio Zazzi 15 , Antonio Di Biagio 16
Affiliation  

ABSTRACT

Introduction

Antiretroviral therapy (ART) is the most significant advance in the medical management of HIV-1 infection. Given the fact that HIV cannot be eradicated from the body, ART has to be indefinitely maintained. New approaches need to be defined for monitoring HIV-infected individuals (PLWHIV), including clinical, virologic, immunological parameters and also ways to collect individual points of view and quality of life.

Areas covered

We discuss which tests may be used to improve the management of PLWHIV and respond to a comprehensive health demand.

Expert opinion

Viral load and CD4 counts are well-validated outcome measures and we still need them, but they do not completely depict the health status of PLWHIV. We need to better understand and to apply to clinical practice what happens in sanctuaries, what is the role of HIV DNA, what is the meaning of low-level viremia. Most of these questions do not yet have a definitive response. Further, we need to understand how to modify these variables in order to improve outcomes.

Similar points may be raised for immunological measures and for tests exploring the tolerability of drugs. The goal must be the evolution from a viro/immunologic-based to a comprehensive quality-of-health-based evaluation of PLWHIV.



中文翻译:

加强对 HIV 感染者的护理:当前和未来的监测方法

摘要

介绍

抗逆转录病毒疗法 (ART) 是 HIV-1 感染医学管理中最重要的进步。鉴于 HIV 无法从体内根除,因此必须无限期维持抗病毒治疗。需要定义新的方法来监测 HIV 感染者 (PLWHIV),包括临床、病毒学、免疫学参数以及收集个人观点和生活质量的方法。

覆盖区域

我们讨论了可以使用哪些测试来改善 PLWHIV 的管理和应对全面的健康需求。

专家意见

病毒载量和 CD4 计数是经过充分验证的结果指标,我们仍然需要它们,但它们并不能完全描述 PLWHIV 的健康状况。我们需要更好地理解并应用于临床实践中发生在庇护所中的情况,HIV DNA 的作用是什么,低水平病毒血症的含义是什么。这些问题中的大多数还没有明确的答案。此外,我们需要了解如何修改这些变量以改善结果。

对于免疫学措施和探索药物耐受性的测试,可能会提出类似的观点。目标必须是从基于病毒/免疫学的评估演变为基于健康质量的综合评估 PLWHIV。

更新日期:2020-10-15
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