JAC Advance Access originally published online on September 8, 2005
Journal of Antimicrobial Chemotherapy 2005 56(5):808-818; doi:10.1093/jac/dki320
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Once-daily antiretroviral therapy: Spanish Consensus Statement
1 Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; 2 Hospital Universitari Vall d'Hebron, Barcelona, Spain; 3 Hospital Ramón y Cajal, Madrid, Spain; 4 Hospital Infanta Cristina, Badajoz, Spain; 5 Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; 6 Hospital Clínico Universitario, Valladolid, Spain; 7 Hospital Reina Sofía, Córdoba, Spain; 8 Hospital Nuestra Señora de Aránzazu, San Sebastián, Spain; 9 Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; 10 Hospital de Basurto, Bilbao, Spain; 11 Hospital Universitario Virgen del Rocío, Seville, Spain; 12 Hospital Universitario Son Dureta, Palma de Mallorca, Spain; 13 Hospital Dr Peset, Valencia, Spain; 14 Hospital Marina Baixa, Villajoyosa, Alicante, Spain; 15 Centro Penitenciario Madrid IV, Navalcarnero, Madrid, Spain; 16 Hospital Clinic-IDIBAPS, Barcelona, Spain; 17 Hospital Virgen de la Victoria, Málaga, Spain
* Corresponding author. Fax: +34-91-3908614; E-mail: fpulido{at}ya.com
Background: Administration of antiretroviral therapy (ART) once daily is creating extraordinary interest among the members of the scientific community and also among those who receive the therapy. However, in clinical practice, some doubts remains about its use.
Objectives: This document examines the characteristics and possibilities of treatment administered once daily.
Methods: Consensus of 248 Spanish experts in the field.
Results: Once-daily dosing is considered an added value which could favour adherence and, therefore, efficacy, as well as the quality of life of certain patients, however, the objective of adequate adherence in the long term is often difficult to achieve regardless of the treatment used. In theory, any patient can receive once-daily therapy, although some patients could particularly benefit from it, e.g. those with unfavourable social or personal circumstances, including drug users, patients whose treatment must be supervised, patients receiving multiple medications, or those who need rescue therapy after multiple treatment failures. At present, it is possible to design once-daily ART using some of the combinations of drugs considered as first-choice in national and international recommendations for antiretroviral therapy, but the options are still limited. The marketing of new drugs with this characteristic could allow us to increase the number and types of patient who can benefit from once-daily regimens, including those patients who need rescue therapy.
Conclusions: Once-daily ART is a good alternative to regimens administered several times each day when a potent combination of active drugs is available.
Keywords: HIV therapy , antiretrovirals , HAART
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