Background: Meeting the challenge of antiretroviral therapy (ART) whose efficacy can last a lifetime requires continuous updating of the virological, pharmacological, and quality of life outcomes to be pursued and a continuous review of literature data on the efficacy and tolerability of new drugs and therapeutic strategies. Methods: With the aim of identifying open questions and answers about the current controversies in modern ART, we adapted the Design Thinking methodology to the needs of the design phase of a scientific article, involving a team of experts in HIV care. Results: Five main pillars of treatment success were discussed: sustained virologic suppression over time; immunological recovery; pharmacological attributes; long-term tolerability and safety of ART; and people's satisfaction and quality of life. The definition of the outcomes to be achieved in each thematic area and the tools to achieve them were reviewed and discussed. Conclusions: Long-term treatment success should be intended as a combination of HIV-RNA suppression, immune recovery, and high quality of life. To achieve this, the regimen should be well-tolerated, with high potency, genetic barrier, and forgiveness, and should be tailored by a person-centered perspective, based on individual needs, preferences, and therapeutic history.

Pillars of long-term antiretroviral therapy success / Taramasso, L.; Andreoni, M.; Antinori, A.; Bandera, A.; Bonfanti, P.; Bonora, S.; Borderi, M.; Castagna, A.; Cattelan, A. M.; Celesia, B. M.; Cicalini, S.; Cingolani, A.; Cossarizza, A.; D'Arminio Monforte, A.; D'Ettorre, G.; Di Biagio, A.; Di Giambenedetto, S.; Di Perri, G.; Esposito, V.; Foca, E.; Gervasoni, C.; Gori, A.; Gianotti, N.; Guaraldi, G.; Gulminetti, R.; Lo Caputo, S.; Madeddu, G.; Maggi, P.; Marandola, G.; Marchetti, G. C.; Mastroianni, C. M.; Mussini, C.; Perno, C. F.; Rizzardini, G.; Rusconi, S.; Santoro, M.; Sarmati, L.; Zazzi, M.; Maggiolo, F.. - In: PHARMACOLOGICAL RESEARCH. - ISSN 1043-6618. - 196:(2023). [10.1016/j.phrs.2023.106898]

Pillars of long-term antiretroviral therapy success

Castagna A.;
2023-01-01

Abstract

Background: Meeting the challenge of antiretroviral therapy (ART) whose efficacy can last a lifetime requires continuous updating of the virological, pharmacological, and quality of life outcomes to be pursued and a continuous review of literature data on the efficacy and tolerability of new drugs and therapeutic strategies. Methods: With the aim of identifying open questions and answers about the current controversies in modern ART, we adapted the Design Thinking methodology to the needs of the design phase of a scientific article, involving a team of experts in HIV care. Results: Five main pillars of treatment success were discussed: sustained virologic suppression over time; immunological recovery; pharmacological attributes; long-term tolerability and safety of ART; and people's satisfaction and quality of life. The definition of the outcomes to be achieved in each thematic area and the tools to achieve them were reviewed and discussed. Conclusions: Long-term treatment success should be intended as a combination of HIV-RNA suppression, immune recovery, and high quality of life. To achieve this, the regimen should be well-tolerated, with high potency, genetic barrier, and forgiveness, and should be tailored by a person-centered perspective, based on individual needs, preferences, and therapeutic history.
2023
Antiretroviral therapy
Immunological recovery
Pharmacological attributes
Quality of life
Safety
Virologic suppression
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11768/152644
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