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Desde los primeros años de la utilización de la terapia antirretroviral de gran actividad (TARGA) rápidamente se observaron dos hechos: su gran efectividad y la importancia de un correcto cumplimiento para conseguir los objetivos terapéuticos. Los regímenes terapéuticos han cambiado recientemente, las pautas complejas con una elevada carga de comprimidos, dosificación de tres veces al día y restricciones alimentarias ha dado paso a tratamientos más sencillos
Los principales avances han sido: nuevas formulaciones y nuevos fármacos que permiten la dosificación de una vez al día, la utilización de ritonavir para potenciar la biodisponibilidad de los inhibidores de proteasa y la coformulación de principios activos en una sola cápsula. En la presente revisión se analizan los factores facilitadores y las barreras para una adhesión óptima y el impacto de las intervenciones en el régimen terapéutico. La adherencia es un problema multidimensional complejo; la simplificación del tratamiento constituye un aspecto importante; sin embargo, debe acompañarse de otras estrategias enfocadas al paciente y al equipo asistencial para lograr el objetivo de una terapia antirretroviral efectiva prolongada en todos los pacientes
Palabras clave:
Tratamiento antirretroviral
VIH
Adherencia
Cumplimiento
Intervenciones
Within the first few years after the introduction of highly active antiretroviral therapy two facts became evident: the treatment was highly effective and proper compliance was essential to achieve the therapeutic objectives. Recently, the regimens containing these drugs have changed. Complex dosing with a large number of tablets taken three times daily together with dietary restrictions has given way to simpler treatments. The main advances include new formulations and new drugs that allow once-daily dosing, the use of ritonavir to enhance the bioavailability of the protease inhibitors and the coformulation of active ingredients in a single capsule. This review analyzes the impact of these interventions on the therapeutic regimen and it discusses the factors that facilitate and those that hinder optimal adherence to highly active antiviral treatment
Adherence is a complex, multidimensional problem. Simplification of the treatment is an important aspect, but it should be accompanied by other strategies focussed on the patient and the medical team in order to achieve effective long-term antiretroviral therapy in all patients
Key words:
Antiretroviral treatment
HIV
Adherence
Compliance
Interventions
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