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JAC Advance Access published online on September 8, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dki320
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Review

Once-daily antiretroviral therapy: Spanish Consensus Statement

F. Pulido 1* {dagger}, E. Ribera 2 {dagger}, S. Moreno 3, A. Muñoz 4, D. Podzamczer 5, M. A. del Pozo 6, A. Rivero 7, F. Rodríguez 8, I. Sanjoaquín 9, R. Teira 10, P. Viciana 11, C. Villalonga 12, A. Antela 3, J. Carmena 13, J. Ena 14, E. Gonzalez 15, J. M. Kindelán 7, J. Mallolas 16, M. Márquez 17, and E. Martínez 16

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

* To whom correspondence should be addressed.
F. Pulido, E-mail: fpulido{at}ya.com


  Abstract

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.
{dagger}These authors contributed equally to this document.
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