title: Executive summary of the GESIDA/National AIDS Plan Consensus Document on antiretroviral therapy in adults infected by the human immunodeficiency virus (updated January 2015).
abstract: In this update, antiretroviral therapy (ART) is recommended for all patients infected by type 1 human immunodeficiency virus (HIV-1). The strength and grade of the recommendation vary depending on the CD4+ T-lymphocyte count, the presence of opportunistic infections or comorbid conditions, age, and the efforts to prevent the transmission of HIV. The objective of ART is to achieve an undetectable plasma viral load (PVL). Initial ART should comprise three drugs, namely, two nucleoside reverse transcriptase inhibitors (NRTI) and one drug from another family. Three of the recommended regimens, all of which have an integrase strand transfer inhibitor (INSTI) as the third drug, are considered a preferred regimen; a further seven regimens, which are based on an INSTI, an non-nucleoside reverse transcriptase inhibitor (NNRTI), or a protease inhibitor boosted with ritonavir (PI/r), are considered alternatives. The reasons and criteria for switching ART are presented both for patients with an undetectable PVL and for patients who experience virological failure, in which case the rescue regimen should include three (or at least two) drugs that are fully active against HIV. The specific criteria for ART in special situations (acute infection, HIV-2 infection, pregnancy) and comorbid conditions (tuberculosis and other opportunistic infections, kidney disease, liver disease, and cancer) are updated.
authors.forename: Juan
authors.initials: J
authors.lastname: Berenguer
authors.forename: Rosa
authors.initials: R
authors.lastname: Polo
authors.forename: José López
authors.initials: JL
authors.lastname: Aldeguer
authors.forename: Fernando
authors.initials: F
authors.lastname: Lozano
authors.forename: Koldo
authors.initials: K
authors.lastname: Aguirrebengoa
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Arribas
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Blanco
authors.forename: Vicente
authors.initials: V
authors.lastname: Boix
authors.forename: José Luis
authors.initials: JL
authors.lastname: Casado
authors.forename: Bonaventura
authors.initials: B
authors.lastname: Clotet
authors.forename: Manuel
authors.initials: M
authors.lastname: Crespo
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.forename: Vicente
authors.initials: V
authors.lastname: Estrada
authors.forename: Federico
authors.initials: F
authors.lastname: García
authors.forename: José María
authors.initials: JM
authors.lastname: Gatell
authors.forename: Juan
authors.initials: J
authors.lastname: González-García
authors.forename: Félix
authors.initials: F
authors.lastname: Gutiérrez
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Iribarren
authors.forename: Hernando
authors.initials: H
authors.lastname: Knobel
authors.forename: Josep María
authors.initials: JM
authors.lastname: Llibre
authors.forename: Jaime
authors.initials: J
authors.lastname: Locutura
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: López
authors.forename: José M
authors.initials: JM
authors.lastname: Miró
authors.forename: Santiago
authors.initials: S
authors.lastname: Moreno
authors.forename: Daniel
authors.initials: D
authors.lastname: Podzamczer
authors.forename: Joaquín
authors.initials: J
authors.lastname: Portilla
authors.forename: Federico
authors.initials: F
authors.lastname: Pulido
authors.forename: Esteban
authors.initials: E
authors.lastname: Ribera
authors.forename: Melchor
authors.initials: M
authors.lastname: Riera
authors.forename: Rafael
authors.initials: R
authors.lastname: Rubio
authors.forename: Jesús
authors.initials: J
authors.lastname: Santos
authors.forename: José
authors.initials: J
authors.lastname: Sanz-Moreno
authors.forename: Jesús
authors.initials: J
authors.lastname: Sanz
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Téllez
authors.forename: Montserrat
authors.initials: M
authors.lastname: Tuset
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivero
mesh_terms: D017088:AIDS-Related Opportunistic Infections; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001942:Breast Feeding; D018791:CD4 Lymphocyte Count; D015897:Comorbidity; D000075202:Contraindications; D024882:Drug Resistance, Viral; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1 / Q000187:drug effects; D015498:HIV-2; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D019562:Viral Load; D014766:Viremia / Q000188:drug therapy
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS; Antiretroviral treatment; GESIDA; Guideline; Guía; Human immunodeficiency virus infection; Infección por el virus de la inmunodeficiencia humana; Plan Nacional sobre el SIDA; Sida; Spanish National AIDS Plan; Tratamiento antirretroviral