Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học quốc tế đề tài : Disease Management Constructing Optimal NRTI-Based | Journal of the International AIDS Society BioMed Central Review article Disease Management Constructing Optimal NRTI-Based Combinations Past Present and Future Douglas T Dieterich Address Vice Chair and Chief Medical Officer Department of Medicine The Mount Sinai Medical Center New York NY Email Douglas T Dieterich - Open Access Published 19 January 2006 Journal of the International AIDS Society 2006 8 16 This article is available from http content 8 l l6 Introduction More than a decade ago it became apparent that treatment of HIV infection with only 1 antiretroviral agent was associated with the rapid development of resistance. 1 Clinical trials conducted at that time showed that combining 2 antiretroviral agents improved virologic and immunologic responses compared with use of a single agent. Accordingly 2-drug combination antiretroviral therapy became the standard of care to maintain viral suppression and minimize the emergence of resistant strains and thereby reduce the risk of disease progression and death. Subsequent experience and clinical trials showed that 3drug combinations were substantially more effective than 2-drug combinations. Recommended 3-drug regimens of highly-active antiretroviral therapy HAART generally include 2 nucleoside or nucleotide analog reverse transcriptase inhibitors NRTIs plus 1 nonnucleoside analog reverse transcriptase inhibitor NNRTI or 1 protease inhibitor PI . There are 8 NRTIs 9 PIs 3 NNRTIs and 1 fusion inhibitor as well as 4 coformulated NRTI combinations currently approved for use in the United States. The most recent US Department of Health and Human Services DHHS guidelines for initial therapy in HIV-infected adults and adolescents include 91 potential HAART regimens 70 combinations of 2 NRTIs plus a PI of which 30 combinations use a PI boosted with low-dose ritonavir 20 combinations of 2 NRTIs plus an NNRTI and 1 triple NRTI. 2 Of the 90 potential combinations 6 are .
