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Redefining therapeutic success in HIV patients: an expert view

2021; Oxford University Press; Volume: 76; Issue: 10 Linguagem: Inglês

10.1093/jac/dkab168

1460-2091

Antonio Antela, Antonio Rivero, Josep M. Llibre, Santiago Moreno, Antonio Antela, Josep M. Llibre, Santiago Moreno, Antonio Rivero, Marta Montero, Enrique Bernal, José Ramón Blanco Ramos, Manuel Castaño, David Dalmau Juanola, Belén de la Fuente García, Carlos Dueñas, Núria Espinosa, Vicente Estrada, M. Puerto, Miguel García del Toro, Juan González, Miguel Górgolas, Carmen Hidalgo-Tenorio, Hernando Knobel Freu, Juan Carlos López Bernaldo de Quirós, Juan Macías Sánchez, C. Ruiz, E. Martínez Chamorro, Mar Masiá, M. Rodríguez Miguélez, Celia Miralles, Julián Olalla, Esteban Ribera, Francisco Félix Rodríguez-Vidigal, Rafael Rubio, Santos Jesús,

HIV Research and Treatment

Thanks to advances in the field over the years, HIV/AIDS has now become a manageable chronic condition. Nevertheless, a new set of HIV-associated complications has emerged, related in part to the accelerated ageing observed in people living with HIV/AIDS, the cumulative toxicities from exposure to antiretroviral drugs over decades and emerging comorbidities. As a result, HIV/AIDS can still have a negative impact on patients' quality of life (QoL). In this scenario, it is reasonable to believe that the concept of therapeutic success, traditionally associated with CD4 cell count restoration and HIV RNA plasma viral load suppression and the absence of drug resistances, needs to be redefined to include other factors that reach beyond antiretroviral efficacy. With this in mind, a group of experts initiated and coordinated the RET Project, and this group, using the available evidence and their clinical experience in the field, has proposed new criteria to redefine treatment success in HIV, arranged into five main concepts: rapid initiation, efficacy, simplicity, safety, and QoL. An extensive review of the literature was performed for each category, and results were discussed by a total of 32 clinicians with experience in HIV/AIDS (4 coordinators + 28 additional experts). This article summarizes the conclusions of these experts and presents the most updated overview on the five topics, along with a discussion of the experts' main concerns, conclusions and/or recommendations on the most controversial issues.