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Antiretrovirale Therapie: Wie beginnen und wie fortsetzen?

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HIV-Infekt

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Zusammenfassung

Mit den heute zur Verfügung stehenden antiretroviralen Medikamenten läßt sich die Virusbeladung im Plasma gegenüber dem Ausgangswert um mehr als 90 % senken. Ein frühzeitiger Therapiebeginn ermöglicht eine fast komplette Hemmung der Virusreplikation und verzögert die Selektion von resistenten Virusmutanten. Die Behandlung der HIV-Infektion sollte von Anfang an mit einer Kombinationstherapie erfolgen. Das Kriterium für eine effektive Therapie mit den heute zur Verfügung stehenden Medikamenten ist eine initiale Senkung der Virusbeladung im Plasma um mindestens das 10- bis 100fache des Ausgangswertes (1–2-Log 10-Reduktion) innerhalb der ersten 2–4 Therapiewochen, die über einen längeren Zeitraum (> 6 Monate) nachweisbar bleibt. Das Versagen einer Therapie kann durch eine regelmäßige Überwachung, die virologische, immunologische und klinische Untersuchungen einschließt, ermittelt werden. Unter Hinzunahme von phänotypischen Resistenzuntersuchungen läßt sich die Ursache eines progredienten Verlaufs differentialdiagnostisch abklären und die Therapie ermitteln, gegen die die Viruspopulation des Patienten resistent bzw. noch empfindlich ist. Als Folgetherapien sollten bevorzugt Kombinationen unter Einschluß von Proteaseinhibitoren zum Einsatz kommen.

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Authors
  1. S. Staszewski
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  2. V. Miller
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Editors and Affiliations

  1. Klinik und Poliklinik für Dermatologie, Venerologie, Allergologie, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Germany

    Norbert H. Brockmeyer  & Lutz Mertins  & 

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© 1997 Springer-Verlag Berlin Heidelberg

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Staszewski, S., Miller, V. (1997). Antiretrovirale Therapie: Wie beginnen und wie fortsetzen?. In: Brockmeyer, N.H., Mertins, L. (eds) HIV-Infekt. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60722-6_4

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  • DOI: https://doi.org/10.1007/978-3-642-60722-6_4

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64525-9

  • Online ISBN: 978-3-642-60722-6

  • eBook Packages: Springer Book Archive

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