PACTG 390-COMBINATION ANTIRETROVIRAL REGIMENS IN ANTIRETROVIRAL NANVE CHILDREN

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 转换治疗的最佳标准尚未确定。有一种合乎逻辑的论据支持严格控制病毒复制。 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无法检测的极限)，则应切换到不同的、可能更密集的方案。考虑到儿童可用药物的局限性，这种方法的问题是，这项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，尝试最大限度地发挥每种方案的好处，只有在病毒载量始终高于较高阈值的情况下才进行切换。这一策略将保留更长时间的选择，而且有一些证据表明，尽管HAART，病毒复制可能在体内致病性较低。

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.