HAART Strategies for Better Results of HAART

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1 ,**1 The Japanese Society for AIDS Research The Journal of AIDS Research,* - HAART Symposium - Strategies for Better Results of HAART Satoshi KIMURA HIVAIDS Takuma SHIRASAKA HAART * HAART HIV HAART HAART STI HAART HAART HAART HIV 0 HAART HIVAIDS HIV HIV Highly active antiretroviral therapy HAART HIV : *,2132,+.,-,**1., DHHS HIV,,/ +* HIV +330 Hit HIV early and Hard HIV 3+ +

2 S Kimura et al : Symposium : Strategies for Better Results of HAART, HIV HAART HIV HIV HAART HIV HIV HIV adherence AIDS CD. T HAART CD. T,** -/* CD. T,** CD. T CD. T -/*. HIV,* HBV B HBV EFV EFV - / HAART HAART + CD. T ml / CD. T,** 0 /* ml CD. T AIDS AIDS HIV QOL QOL HIV AIDS 3,,

3 The Journal of AIDS Research Vol. 3 No.,,**1 HIV 0 HIV HIV + Report of the NIH panel to define principles of therapy of HIV infection. MMWR.1 (RR-/) :+.+, +332., Guidelines for the Use of Antiretroviral Agents in HIV- Infected Adults and Adolescents. Department of Health and Human Services (DHHS).,**0 * * - Hammer SM et al. : Treatment for Adult HIV Infection. Recommendations of the International AIDS Society USA Panel. JAMA,30 (1) :2,12.-,,**0.. HIV +* HIV,**0 + / HIV +1 HIV,**0 - HAART Highly active antiretroviral therapy HAART + CD. CD.,**mL HIV CD. -/*ml CD.,**-/*mL CD. HIV-RNA HAART : 331,**+ 2 HAART,**0 2 2/ HAART CD. HIV-RNA AIDS : 2/ /.*.1 P*.*/ CD. +** HAART : *.34/,,01*.* +2. HIV-+ RNA cml4,*+* / +4++* - +4/+* 1 HIV-+ RNA+**5*** /143 CD. cellsmm - 0,mL +/*2 CD.,** ,1.*41,00 114/,2+*0 HIV-+ RNA cml4-.+* / +42+* - 14/+* 0 HIV-+ RNA+**5*** /.42 CD. cellsmm - *3mL +203 CD.,** 0+4. *P*.*+ 3- -

4 S Kimura et al : Symposium : Strategies for Better Results of HAART HAART +** 3, 0 HIV-RNA **,*** copiesml +*, HAART AIDS AIDS 1/ +- AIDS ++* 0 P*.*/ AIDS AIDS / - AIDS, ATL, HCV AIDS, AIDS HIV + efavirenz : HAART HIV,, - + Egger M, May M, Chene G, Phillips AN, Ledergerber B, Dabis F, Costagliola D, D Arminio Monforte A, de Wolf F, Reiss P, Lundgren JD, Justice AC, Staszewski S, Leport C, Hogg RS, Sabin CA, Gill MJ, Salzberger B, Sterne JA : ART Cohort Collaboration. Prognosis of HIV-+-infected patients starting highly active antiretroviral therapy : a collaborative analysis of prospective studies. Lancet -0* : ++3+,3,,**,., Cooksley CD, Hwang LY, Waller DK, Ford CE : HIVrelated malignancies : community-based study using linkage of cancer registry and HIV registry data. Int J STD AIDS +* : 13/2*,, Chiao EY, Krown SE : Update on non-acquired immunodeficiency syndrome-defining malignancies. Curr Opin Oncol +/ : ,,**-. HAART

5 The Journal of AIDS Research Vol. 3 No.,,**1 +, -. / HIV-RNA+*** copiesml, IAS USA + DHHS, European - +. Hirsch MS, et al. : Clin Infect Dis -1 : ++-+,2,,**-.,. Available at : http : // Oct.,**0. -. Vandamme AM, et al. : Antivir Ther 3 : 2,32.2,,**.. Stanford HIV RT and Protease Seqence Detabase : http : //HIV db. stanford. edu/ HIV-+ HIV HAART, DHHS 0+0 -/ / 3/ /

6 S Kimura et al : Symposium : Strategies for Better Results of HAART HAART, HAART RNA,. - HIV, -TC M+2.V M+2.V Stanford http : // HIVdb.stanford.edu SNPs + efavirenz cytochrome P./*,B0 efavirenz EFV EFV EFV cytochrome P./*,B0 CYP,B0 CYP,B0 *+ *0 *0 *+ *0 EFV + CYP,B0 *0*0./ EFV 0** mgday CYP,B0 *0*0 EFV CYP,B0 *0*0 EFV.** mg.** mg,** mg EFV EFV CYP,B0 *0*0 ** HIV CYP, B0 EFV CYP,B0 *0*0 0 EFV *0 EFV EFV CYP,B0 30 0

7 The Journal of AIDS Research Vol. 3 No.,,**1 CYP,B0 EFV +*+. CYP,B0 *0*0 EFV, abacavir, nevirapine HLA HIV abacavir ABC nevirapine NVP ABC + +* /2 HLA-B/1 ABC HLA B/1 ABC ABC B/1 ABC HLA B/1 ABC ABC NVP NVP HLA Cw2 B+. NVP B+. NVP NVP Cw2., vs +* p*.*-, HLA-Cw2 NVP NVP NVP HLA-Cw2 + Tsuchiya K Gatanaga H, Tachikawa N, Teruya K, Kikuchi Y, Yoshino M, Kuwahara T, Shirasaka T, Kimura S, Oka S : Homozygous CYP,B0 *0 (Q+1,H and K,0,R) correlates with high plasma efavirenz concentrations in HIV-+ patients treated with standard efavirenz-containing regimens. Biochem Biophys Res Commun -+3 : +-,,+-,0,,**.., Gatanaga H, Yazaki H, Tanuma J, Honda M, Genka I, Teruya K, Tachikawa N, Kikuchi Y, Oka S : HLA-Cw2 primarily associated with hypersensitivity to nevirapine. AIDS,+ :,0.,0/,,**

S Kimura et al : Symposium : Strategies for Better Results of HAART HIV HAART HIV AIDS IRS AIDS IRS IRS,**.,**0 *,01 AIDS 2, IRS AIDS HAART CD. HIV IRS AIDS2, PCP -/ +/ MAC 2 2 HIV /. IRS AIDS2, 0.

8 S Kimura et al : Symposium : Strategies for Better Results of HAART HIV HAART HIV AIDS IRS AIDS IRS IRS,**.,**0 *,01 AIDS 2, IRS AIDS HAART CD. HIV IRS AIDS2, PCP -/ +/ MAC 2 2 HIV /. IRS AIDS2, 0. +* +0 IRS +* AIDS MAC1 2 1 : 22 IRS PCP. + MAC -+. : +- IRS PCP. IRS PCP, PCP ART + +, bd +,20* pgml, CD. 0*mL /ml HIV +./+* /.-+* 0, ART 1 NSAID ART PSL + mgkg IRS,1 PCP ART -1 +*2- bd +/+ pgml 0,,/* CD. : 1mL +,+.3 HIV,.3+* / copiesml,..+*. -.3+* : 0, : : PC CMV + PCP HIV IRS 3T, PSL mgkg HIV PCP 32 2

The Journal of AIDS Research Vol. 3 No.,,**1 CD. ml HIV-RNA -0 +3 34,+* / TB ART IRS ART mpsl -. 0* 140+* / MAC ART 0, TB,1 +/.

9 The Journal of AIDS Research Vol. 3 No.,,**1 CD. ml HIV-RNA ,+* / TB ART IRS ART mpsl -. 0* 140+* / MAC ART 0, TB,1 +/. /*, /1 +/ /42+* / HIV ART ART 2 IRS NSAID PSL + mgkg /+.,4++* / HIV MAC ART +, NSAID HIV,+ 1,4*+* 0 PCP MAC CMV ART, IRS NSAID PSL + mgkg 0-3*,4++* / PEL primary e#usion lymphoma ART,, MRI MCA PSL b, PSL /** mg PSL+ mgkg MR 33 3

10 S Kimura et al : Symposium : Strategies for Better Results of HAART HIV bd 131 mgml. CD./mL, HIV +.-+* 0 copiesml, CMV C+*+,+,1 +/*,*** cells CMV HIV IRS ART d.t-tcefv MAC 22 IRS + MAC HIV ART,, :,1 : :PCP MRI HAART IRS ART PSL ART PSL * PSL,**0. IRS, /** mg PSL + mgkg 0 MR ART AIDS 0. +* +0 PCP IRS PCP, ART 1 PCP ART IRS -1 bd ART IRS MAC 22 IRS ART 2+, MAC TB MAC ART IRS NSAID, PSL *./+ mgkg ART IRS PSL HIV +331,**0 -,, // +** *

11 The Journal of AIDS Research Vol. 3 No.,,**1 HIV HIV - +, CD.,** - + : +1,**/., : -3 : +*,,**+. - : 0+ : +*+1 +*,,332. +*+ +

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