ABSTRACT
Darunavir es un inhibidor de la proteasa muy activo frente a cepas del virus de la inmunodeficiencia humana salvajes y multirresistentes, lo que ha permitido construir regímenes antirretrovirales eficaces en pacientes expuestos a numerosos antirretrovirales y que albergaban importantes resistencias farmacológicas. Además de su eficacia virológica, darunavir muestra otros aspectos relevantes como su tolerabilidad y su limitada toxicidad, lo que favorecería la adherencia al tratamiento. Estas observaciones son el resultado de numerosos ensayos clínicos (estudios POWER, DUET, BENCHMRK) llevados a cabo en combinación con diferentes antirretrovirales. Estos resultados se han confirmado en otros estudios llevados a cabo en el marco de la práctica clínica habitual, que han incluido el rescate tras fracaso a análogos no nucleósidos o como parte de terapias libres de análogos nucleósidos. Por estos motivos, en el momento actual, darunavir continúa siendo una opción terapéutica eficaz en los pacientes con fracasos terapéuticos previos que precisan un tratamiento antirretroviral optimizado
Darunavir (DRV) is a highly active protease inhibitor against wild-type and multidrug-resistant strains of human immunodeficiency virus that allows the design of effective antiretroviral regimens in patients previously exposed to antiretroviral agents and harboring many important drug resistances to the human immunodeficiency virus. In addition to its virological efficacy, DRV shows other important features, such as its tolerability and its limited toxicity, thereby encouraging adherence. These observations are the result of numerous clinical trials (POWER, DUET, BENCHMRK) carried out in combination with different antiretroviral drugs. These results have been confirmed in other studies conducted in the setting of routine clinical practice that included therapeutic rescue after failure to non-nucleoside analogues or as part of a nucleoside analogue-sparing regimen. For these reasons, DRV continues to be an effective treatment option in patients with previous treatment failures requiring an optimized antiretroviral régimen
Subject(s)
Humans , HIV , Darunavir/therapeutic use , Anti-Retroviral Agents/therapeutic use , HIV Infections/drug therapy , Drug Resistance, Multiple , Medication Adherence , HIV Infections/therapy , Confidence Intervals , Failure to Rescue, Health Care/trendsABSTRACT
Post-exposure prophylaxis (PEP) can be a secondary measure to prevent infection by human immunodeficiency virus (HIV) when primary prevention has failed. PEP is advised for people with sporadic and exceptional risk exposure to HIV. This consensus document about occupational and non-occupational PEP recommendations aims to be a technical document for healthcare professionals. Its main objective is to facilitate the appropriate use of PEP. To this end, some recommendations have been established to assess the risk of transmission in different types of exposure, situations where PEP should be recommended, special circumstances to take into account, antiretroviral (ARV) guidelines including start and end of the treatment, early monitoring of tolerance and adherence to the treatment, subsequent monitoring of people exposed, independently of having received PEP or not, and need of psychological support. This document is intended for all professionals who work in clinical practice in the field of HIV infection.
