Стартовая терапия:2 НИОТ

Предпочтительны	•	Once-daily dosing
е	•	High virologic efficacy
TDF/FTC	•	Active against HBV
	• Potential for renal and bone toxicity
Альтернативные	•	Once-daily dosing
ABC/3TC	• Risk of hypersensitivity reaction if positive for
		HLA-B*5701
	• Possible risk of cardiovascular events; caution in
		patients with CV risk factors
	• Possible inferior efficacy if baseline HIV RNA
		>100,000 copies/mL
Допустимые	•	Twice-daily dosing
ZDV/3TC	• Preferred dual NRTI for pregnant women
	• More toxicities than TDF/FTC or ABC/3TC

March 2012 www.aidsetc.org

Стартовая терапия:

ННИОТ	•EFV/TDF/FTC1,2
ИП	•ATV/r + TDF/FTC²
	•DRV/r (QD) + TDF/FTC²
ИИ	•RAL + TDF/FTC²
Беременные	•LPV/r (BID) + ZDV/3TC²

1.EFV should not be used during the first trimester of pregnancy or in women trying to conceive or not using effective and consistent contraception.

2.3TC can be used in place of FTC and vice versa. TDF should be used with caution in patients with renal insufficiency.

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		Стартовая терапия:
		альтернативная
NNRTI		•EFV¹ + ABC/3TC2,3
based		•RPV + (TDF/FTC or ABC/3TC)2,3

1.EFV should not be used during the first trimester of pregnancy or in women trying to conceive or not using effective and consistent contraception.

2.3TC can be used in place of FTC and vice versa. TDF should be used with caution in patients with renal insufficiency.

3.ABC should not be used in patients who test positive for HLA-B*5701; caution if HIV RNA >100,000 copies/mL, or if high risk of cardiovascular disease.

4.RPV: Use with caution if pretreatment HIV RNA >100,000 copies/mL.

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Стартовая терапия: альтернативная

PI based •ATV/r + ABC/3TC1,2 •DRV/r + ABC/3TC1,2

•FPV/r (QD or BID) + (ABC/3TC or TDF/FTC)1,2

•LPV/r (QD or BID)3 + (ABC/3TC or TDF/FTC)1,2

II based •RAL + ABC/3TC1,2

1.3TC can be used in place of FTC and vice versa. TDF should be used with caution in patients with renal insufficiency.

2.ABC should not be used in patients who test positive for HLA-B*5701; caution if HIV RNA >100,000 copies/mL, or if high risk of cardiovascular disease.

3. QD LPV/r is not recommended in pregnant women.

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March 2012 www.aidsetc.org

Стартовая терапия: допустимая

NNRTI based •EFV¹ + (ZDV/3TC)²

•NVP4 + (TDF/FTC or ZDV/3TC)2 •NVP4 + ABC/3TC2,3

•RPV5 + ZDV/3TC2

1.EFV should not be used during the first trimester of pregnancy or in women trying to conceive or not using effective and consistent contraception.

2.3TC can be used in place of FTC and vice versa. TDF should be used with caution in patients with renal insufficiency.

3.ABC should not be used in patients who test positive for HLA-B*5701; caution if HIV RNA >100,000 copies/mL, or if high risk of cardiovascular disease.

4.NVP should not be started if pre-ARV CD4 >250 in women or >400 in men.

5.RPV: Use with caution if pretreatment HIV RNA >100,000 copies/mL.

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March 2012

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Стартовая терапия: допустимая

PI based •ATV1 + (ABC or ZDV)/3TC2

• ATV/r + ZDV/3TC2

•DRV/r + ZDV/3TC2

•FPV/r + ZDV/3TC2

•LPV/r + ZDV/3TC2,3

1.ATV-r is preferred to unboosted ATV; unboosted ATV may be used when RTV boosting is not possible.

2.3TC can be used in place of FTC and vice versa.

3.Preferred regimen for pregnant women.

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March 2012

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Стартовая терапия: допустимая

II based

•RAL + ZDV/3TC1

CCR5 antagonist •MVC2 + ZDV/3TC1 based •MVC2 + TDF/FTC1,3 or

ABC/3TC1,4

1.3TC can be used in place of FTC and vice versa.

2.Tropism testing required before treatment with MVC; use only if CCR5- tropic virus is present.

3.TDF should be used with caution in patients with renal insufficiency.

4.ABC should not be used in patients who test positive for HLA-B*5701; caution if HIV RNA >100,000 copies/mL, or if high risk of cardiovascular disease.

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March 2012

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Стартовая терапия: нерекомендуемая

Высокая вероятность недостижения раннего

Более низкий вирусологический эффект

•ddI + TDF

•ABC + 3TC + ZDV as 3-NRTI regimen

•ABC + 3TC + ZDV + TDF as 4-NRTI regimen

•ddI + (3TC or FTC)

•FPV (unboosted)

•DLV

•NFV

•SQV as sole PI (unboosted)

•TPV/r

Высокая частота токсичности

•d4T + 3TC

•ddI + TDF

•IDV/r

•RTV as sole PI

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March 2012

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Стартовая терапия: нерекомендуемая

High pill burden/ Dosing inconvenience

Lack of data in initial treatment

No benefit over standard regimens

•IDV (unboosted)

•ABC+ TDF

•ABC + ddI

•DRV (unboosted)

•ENF (T-20)

•ETR

•3-class regimens

•3 NRTIs + NNRTI

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Нельзя!

•ARV regimens not recommended:

–Monotherapy with NRTI*

–Monotherapy with boosted PI

–Dual-NRTI therapy

–3-NRTI regimen (except ABC + 3TC + ZDV or possibly TDF + 3TC + ZDV,

when other regimens are not desirable)

* ZDV monotherapy is not recommended for prevention of perinatal HIV

transmission but might be considered in certain circumstances; see Public Health Service Task Force Recommendations for the Use of Antiretroviral Drugs in Pregnant HIV-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States.

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March 2012

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