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, Lucia; Andreoni, Massimo; Antinori, Andrea; Bandera, Alessandra; Bonfanti, Paolo; Bonora, Stefano; Borderi, Marco; Castagna, Antonella; Cattelan, Anna Maria; Celesia, Benedetto Maurizio; Cicalini, Stefania; Cingolani, Antonella; Cossarizza, Andrea; D'Arminio Monforte, Antonella; D'Ettorre, Gabriella; Di Biagio, Antonio; Di Giambenedetto, Simona; Di Perri, Giovanni; Esposito, Vincenzo; Focà, Emanuele; Gervasoni, Cristina; Gori, Andrea; Gianotti, Nicola; Guaraldi, Giovanni; Gulminetti, Roberto; Lo Caputo, Sergio; Madeddu, Giordano; Maggi, Paolo; Marandola, Giorgio; Marchetti, Giulia Carla; Mastroianni, Claudio Maria; Mussini, Cristina; Perno, Carlo Federico; Rizzardini, Giuliano; Rusconi, Stefano; Santoro, Maria; Sarmati, Loredana; Zazzi, Maurizio; Maggiolo, Franco. - In: PHARMACOLOGICAL RESEARCH. - ISSN 1096-1186. - 196:(2023), p. 106898. [10.1016/j.phrs.2023.106898]

Pillars of long-term antiretroviral therapy success

Cossarizza, Andrea;Madeddu, Giordano;
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
Pillars of long-term antiretroviral therapy success / Taramasso, Lucia; Andreoni, Massimo; Antinori, Andrea; Bandera, Alessandra; Bonfanti, Paolo; Bonora, Stefano; Borderi, Marco; Castagna, Antonella; Cattelan, Anna Maria; Celesia, Benedetto Maurizio; Cicalini, Stefania; Cingolani, Antonella; Cossarizza, Andrea; D'Arminio Monforte, Antonella; D'Ettorre, Gabriella; Di Biagio, Antonio; Di Giambenedetto, Simona; Di Perri, Giovanni; Esposito, Vincenzo; Focà, Emanuele; Gervasoni, Cristina; Gori, Andrea; Gianotti, Nicola; Guaraldi, Giovanni; Gulminetti, Roberto; Lo Caputo, Sergio; Madeddu, Giordano; Maggi, Paolo; Marandola, Giorgio; Marchetti, Giulia Carla; Mastroianni, Claudio Maria; Mussini, Cristina; Perno, Carlo Federico; Rizzardini, Giuliano; Rusconi, Stefano; Santoro, Maria; Sarmati, Loredana; Zazzi, Maurizio; Maggiolo, Franco. - In: PHARMACOLOGICAL RESEARCH. - ISSN 1096-1186. - 196:(2023), p. 106898. [10.1016/j.phrs.2023.106898]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11388/324383
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