CLINICAL TRIAL: PACTG 390-COMBINATION ANTIRETROVIRAL REGIMENS IN ANTIRETROVIRAL

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 转换治疗的最佳标准尚未确定。有一个合乎逻辑的论点赞成严格控制病毒的复制。 因此，这种控制规定，一旦在循环中检测到病毒（或如果血浆病毒载量未能达到不可检测的限度），则应转换为不同的，可能更密集的方案。考虑到儿童可用药物的局限性，这种方法的问题在于，这种政策可能会迅速耗尽所有可用的治疗选择。另一种可能在长期随访中同样有效的方法是尝试最大化每种方案的益处，只有当病毒载量始终高于较高阈值时才转换。这一策略将保留更长的选择，有证据表明，尽管HAART病毒复制可能是体内致病性较低。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The optimal criteria for switching therapy have yet to be defined. There is a logical argument in favor of strict control of the viral replication. Consequently, this control dictates that as soon as virus becomes detectable in the circulation (or if plasma viral load fails to reach undetectable limits), then a switch should be made to a different and probably more intensive regimen. The problem with this approach, given the limitations of drugs available to children, is that this policy may rapidly exhaust all available options for therapy. An alternative approach, which may be equally valid over a long period of followup, would be to try to maximize the benefit of each regimen and switch only when the viral load is consistently above a higher threshold. This strategy will preserve options longer, and there is some evidence that virus replicating despite HAART may be less pathogenic in-vivo.