{"id":20248,"date":"2016-04-01T09:37:09","date_gmt":"2016-04-01T08:37:09","guid":{"rendered":"http:\/\/blog.cofb.cat\/?p=20248"},"modified":"2016-04-01T09:37:09","modified_gmt":"2016-04-01T08:37:09","slug":"quines-novetats-hi-ha-en-el-tractament-del-vih","status":"publish","type":"post","link":"https:\/\/www.cofb.org\/ca\/2016\/04\/01\/quines-novetats-hi-ha-en-el-tractament-del-vih\/","title":{"rendered":"Quines novetats hi ha en el tractament del VIH?"},"content":{"rendered":"<p>La gran incid\u00e8ncia que ha tingut en la poblaci\u00f3 mundial la infecci\u00f3 del virus de la immunodefici\u00e8ncia humana (VIH) ha propiciat un <b>canvi quantitatiu i qualitatiu en la investigaci\u00f3<\/b>. Els aven\u00e7os dels \u00faltims anys han perm\u00e8s ampliar el coneixement sobre el virus, definir les pautes de tractament antiretroviral, fixar les bases del desenvolupament de vacunes, incorporar noves estrat\u00e8gies d\u2019eradicaci\u00f3 i fer de la retrovirologia humana, una de les \u00e0rees m\u00e9s din\u00e0miques de la biomedicina.<\/p>\n<p>Mitjan\u00e7ant una <b>reflexi\u00f3 conjunta amb diferents especialistes<\/b> amb punts de vista diversos sobre el paper d\u2019aquests tractaments en terap\u00e8utica tenint en compte aspectes d\u2019efectivitat i cost-efectivitat, el curs \u201cActualitzaci\u00f3 en el tractament del VIH\u201d, que va acollir el COFB el passat 25 de febrer, va permetre als assistents aprofundir en el coneixement de les noves estrat\u00e8gies en el tractament antiretroviral tenint en compte la barrera gen\u00e8tica i saber com eradicar el virus de la Sida dels reservoris, a banda de saber quins factors cal tenir presents en el maneig dels pacients <i>naive<\/i> (que no han rebut un tractament antiretroviral previ) i abordar la lectura cr\u00edtica de les guies GESIDA, DHHS i EACS. Tamb\u00e9 els va ajudar a aconseguir una opini\u00f3 consistent basada en l\u2019evid\u00e8ncia cl\u00ednica i l\u2019efici\u00e8ncia disponible del grup de f\u00e0rmacs exposat i a evidenciar el cost-efic\u00e0cia dels tractaments. L\u2019activitat va estar organitzada conjuntament amb la <a href=\"http:\/\/www.scfarmclin.org\/\" target=\"_blank\" rel=\"noopener\">Societat Catalana de Farm\u00e0cia Cl\u00ednica<\/a>.<\/p>\n<p><b>Tom\u00e0s Casas\u00edn, vocal d\u2019Hospitals del COFB<\/b>\u00a0i un dels coordinadors de la formaci\u00f3, resumeix els punts m\u00e9s destacats de les intervencions de cadascun dels docents:<\/p>\n<p><b><div class=\"box shadow\">Barrera gen\u00e8tica i implicacions en el tractament antiretroviral<\/b><\/p>\n<p><b><a href=\"http:\/\/blog.cofb.cat\/wp-content\/uploads\/2016\/03\/novetats-tractament-VIH-6.jpg\"><img fetchpriority=\"high\" decoding=\"async\" class=\" wp-image-20260 alignright\" alt=\"novetats-tractament-VIH (6)\" src=\"http:\/\/blog.cofb.cat\/wp-content\/uploads\/2016\/03\/novetats-tractament-VIH-6.jpg\" width=\"298\" height=\"199\" \/><\/a>Ponent: <i>Jos\u00e9 Luis Blanco Ar\u00e9valo,<\/i><\/b><i> investigador de l&#8217;IDIBAPS, especialista en malalties infeccioses de l\u2019Hospital Cl\u00ednic de Barcelona.<\/i><\/p>\n<p>A la primera pon\u00e8ncia \u00e9s va aprofundir en el coneixement de les noves estrat\u00e8gies en el tractament antiretroviral tenint en compte la barrera gen\u00e8tica dels diferents f\u00e0rmacs antiretrovirals (FAR). Es van identificar els diferents tipus de mutacions de resist\u00e8ncia associades a les diferents fam\u00edlies de FAR i de la import\u00e0ncia d&#8217;utilitzar antiretrovirals amb una alta barrera gen\u00e8tica.<\/p>\n<p>Es va destacar el cas del dolutegravir (DTG) que no s&#8217;ha seleccionat cap mutaci\u00f3 de resist\u00e8ncia en cap dels tres assaigs cl\u00ednics en fase III d&#8217;inici de TAR, el que fa pensar que DTG presenta una barrera gen\u00e8tica superior a la d&#8217;altres inhibidors de la integrasa (INI), encara que s&#8217;haur\u00e0 de confirmar quan es disposi de m\u00e9s experi\u00e8ncia i seguiment.<b><\/div><\/b><\/p>\n<p><b><div class=\"box shadow\">Gestionament dels pacients naive i lectura cr\u00edtica de guies (Grupo de Estudio del SIDA (GESIDA), Department of Health and Human Services (DHHS), European AIDS Clinical Society (EACS).<\/b><\/p>\n<p><b><a href=\"http:\/\/blog.cofb.cat\/wp-content\/uploads\/2016\/03\/novetats-tractament-VIH-1.jpg\"><img decoding=\"async\" class=\"alignleft  wp-image-20255\" alt=\"novetats-tractament-VIH (1)\" src=\"http:\/\/blog.cofb.cat\/wp-content\/uploads\/2016\/03\/novetats-tractament-VIH-1.jpg\" width=\"298\" height=\"199\" \/><\/a>Ponent: <i>Josep Vilar\u00f3<\/i><\/b><i>, responsable de Malalties Infeccioses del Consorci Hospitalari de Vic.<\/i><\/p>\n<p>En la seg\u00fcent pot\u00e8ncia es van revisar els diferents factors a tenir en compte en el maneig dels pacients<i> naive<\/i>. Es va fer una lectura cr\u00edtica de les guies <a href=\"http:\/\/www.gesida-seimc.org\/\">GeSIDA<\/a>, <a href=\"https:\/\/aidsinfo.nih.gov\/guidelines\">DHHS<\/a> i <a href=\"http:\/\/www.eacsociety.org\/guidelines\/eacs-guidelines\/eacs-guidelines.html\">EACS<\/a>, on es va poder comprovar les difer\u00e8ncies entre les guies de refer\u00e8ncia i la diversitat d&#8217;opcions disponibles pel tractament antiretroviral (TAR). Es va evidenciar la possibilitat de seleccionar un tractament d&#8217;inici ajustat a les circumst\u00e0ncies de cada pacient.<\/p>\n<p>Finalment, es va debatre la necessitat d&#8217;utilitzar els diferents tractaments antiretrovirals seguint criteris de medicina basada en l&#8217;evid\u00e8ncia cl\u00ednica i, a m\u00e9s, tenir en compte conceptes de cost-efic\u00e0cia i efici\u00e8ncia en les decisions.\u00a0<b><\/div><\/b><\/p>\n<p><b><div class=\"box shadow\"><\/b><b>Eradicaci\u00f3 del virus de la SIDA als reservoris<\/b><\/p>\n<p><b><a href=\"http:\/\/blog.cofb.cat\/wp-content\/uploads\/2016\/03\/novetats-tractament-VIH-2.jpg\"><img decoding=\"async\" class=\" wp-image-20256 alignright\" alt=\"novetats-tractament-VIH (2)\" src=\"http:\/\/blog.cofb.cat\/wp-content\/uploads\/2016\/03\/novetats-tractament-VIH-2.jpg\" width=\"298\" height=\"199\" \/><\/a>Ponent: <i>Sara Mor\u00f3n-L\u00f3pez<\/i><\/b><i>, llicenciada en biotecnologia, investigadora d\u2019IrsiCaixa.<\/i><\/p>\n<p>Despr\u00e9s de discutir sobre els conceptes de barrera gen\u00e8tica, les seves implicacions i fer una lectura cr\u00edtica de les diferents guies de refer\u00e8ncia, la Dra. Mor\u00f3n-L\u00f3pez va fer una revisi\u00f3 de les alternatives actualment investigades per eradicar el virus de la Sida dels reservoris.<\/p>\n<p>El tema es va abordar partint dels conceptes b\u00e0sics com l&#8217;alta variabilitat gen\u00e8tica del virus i la integraci\u00f3 de l&#8217;ADN viral en el genoma de la c\u00e8l\u00b7lula diana (limf\u00f2cits CD4); per acabar amb les diferents estrat\u00e8gies per a la curaci\u00f3, definint dos objectius: eradicaci\u00f3 (virus completament eliminat del cos) i la curaci\u00f3 funcional (el virus no s&#8217;elimina totalment del cos, per\u00f2 s&#8217;aconsegueix mantenir indetectable sense necessitat de FAR).<\/p>\n<p>Es van definir les diferents estrat\u00e8gies per a la curaci\u00f3. B\u00e0sicament s\u00f3n 5: la intensificaci\u00f3 i optimitzaci\u00f3 del TAR, la reactivaci\u00f3 de la lat\u00e8ncia, les vacunes terap\u00e8utiques, les immunoter\u00e0pies i la ter\u00e0pia cel\u00b7lular o g\u00e8nica.<\/p>\n<p>Per finalitzar es va fer un debat sobre les diferents opcions i de la import\u00e0ncia de poder seguir avan\u00e7ant per aquestes l\u00ednies d&#8217;investigaci\u00f3.<b><\/div><\/b><\/p>\n<p><b><div class=\"box shadow\">Adher\u00e8ncia a la TAR i motius de simplificaci\u00f3<\/b><\/p>\n<p><b><a href=\"http:\/\/blog.cofb.cat\/wp-content\/uploads\/2016\/03\/novetats-tractament-VIH-7.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft  wp-image-20261\" alt=\"novetats-tractament-VIH (7)\" src=\"http:\/\/blog.cofb.cat\/wp-content\/uploads\/2016\/03\/novetats-tractament-VIH-7.jpg\" width=\"320\" height=\"212\" \/><\/a>Ponent: <i>Maite Mart\u00edn,<\/i><\/b><i> farmac\u00e8utica adjunta al Servei de Farm\u00e0cia de l\u2019Hospital Cl\u00ednic de Barcelona.<\/i><\/p>\n<p>Per concloure el curs la Dra. Mart\u00edn va abordar el tema de l&#8217;adher\u00e8ncia, concepte fonamental en l&#8217;\u00e0mbit del TAR i clarament relacionat amb els objectius proposats de indetectabilitat i augment dels limf\u00f2cits CD4. Per a aix\u00f2, es va partir del concepte d&#8217;adher\u00e8ncia i dels diferents m\u00e8todes de mesura amb els seus avantatges, inconvenients i la seva aplicabilitat.<\/p>\n<p>Es van destacar els aven\u00e7os en els darrers anys pel que fa a la coformulaci\u00f3 de FAR en comprimit \u00fanic (<i>Single Tablet Regiment<\/i>) emfatitzant la import\u00e0ncia de la simplificaci\u00f3 com a eina per aconseguir l&#8217;objectiu de la m\u00e0xima adher\u00e8ncia possible.<b><\/div><\/b><\/p>\n<p align=\"right\"><b>Amb la col\u00b7laboraci\u00f3 de:<\/b><\/p>\n<p align=\"right\"><b><a href=\"http:\/\/www.janssen.es\/\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-6780 alignright\" alt=\"janssen_logo\" src=\"http:\/\/blog.cofb.cat\/wp-content\/uploads\/2014\/06\/janssen_logo.jpg\" width=\"100\" height=\"49\" \/><\/a><\/b><\/p>\n","protected":false},"excerpt":{"rendered":"<p>La gran incid\u00e8ncia que ha tingut en la poblaci\u00f3 mundial la infecci\u00f3 del virus de la immunodefici\u00e8ncia humana (VIH) ha propiciat un canvi quantitatiu i qualitatiu en la investigaci\u00f3. Els aven\u00e7os dels \u00faltims anys han perm\u00e8s ampliar el coneixement sobre el virus, definir les pautes de tractament antiretroviral, fixar les [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":20258,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[57],"tags":[2359,480,56,2172,232],"class_list":["post-20248","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-mon-collegial","tag-antiretroviral","tag-farmacia-hospitalaria","tag-investigacio","tag-sida","tag-vih"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Quines novetats hi ha en el tractament del VIH? - Col\u00b7legi de Farmac\u00e8utics de Barcelona<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/novaorg.cofb.net\/2016\/04\/01\/quines-novetats-hi-ha-en-el-tractament-del-vih\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Quines novetats hi ha en el tractament del VIH? - Col\u00b7legi de Farmac\u00e8utics de Barcelona\" \/>\n<meta property=\"og:description\" content=\"La gran incid\u00e8ncia que ha tingut en la poblaci\u00f3 mundial la infecci\u00f3 del virus de la immunodefici\u00e8ncia humana (VIH) ha propiciat un canvi quantitatiu i qualitatiu en la investigaci\u00f3. Els aven\u00e7os dels \u00faltims anys han perm\u00e8s ampliar el coneixement sobre el virus, definir les pautes de tractament antiretroviral, fixar les [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/novaorg.cofb.net\/2016\/04\/01\/quines-novetats-hi-ha-en-el-tractament-del-vih\/\" \/>\n<meta property=\"og:site_name\" content=\"Col\u00b7legi de Farmac\u00e8utics de Barcelona\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/farmaceuticsbcn\/\" \/>\n<meta property=\"article:published_time\" content=\"2016-04-01T08:37:09+00:00\" \/>\n<meta name=\"author\" content=\"wpAdminCofbOrg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@farmaceuticsbcn\" \/>\n<meta name=\"twitter:site\" content=\"@farmaceuticsbcn\" \/>\n<meta name=\"twitter:label1\" content=\"Escrit per\" \/>\n\t<meta name=\"twitter:data1\" content=\"wpAdminCofbOrg\" \/>\n\t<meta name=\"twitter:label2\" content=\"Temps estimat de lectura\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minuts\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/novaorg.cofb.net\/2016\/04\/01\/quines-novetats-hi-ha-en-el-tractament-del-vih\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/novaorg.cofb.net\/2016\/04\/01\/quines-novetats-hi-ha-en-el-tractament-del-vih\/\"},\"author\":{\"name\":\"wpAdminCofbOrg\",\"@id\":\"https:\/\/www.cofb.org\/#\/schema\/person\/22ed7eea88da74b0fa4d3154ad87ffcb\"},\"headline\":\"Quines novetats hi ha en el tractament del VIH?\",\"datePublished\":\"2016-04-01T08:37:09+00:00\",\"dateModified\":\"2016-04-01T08:37:09+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/novaorg.cofb.net\/2016\/04\/01\/quines-novetats-hi-ha-en-el-tractament-del-vih\/\"},\"wordCount\":988,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/www.cofb.org\/#organization\"},\"image\":{\"@id\":\"https:\/\/novaorg.cofb.net\/2016\/04\/01\/quines-novetats-hi-ha-en-el-tractament-del-vih\/#primaryimage\"},\"thumbnailUrl\":\"\",\"keywords\":[\"antiretroviral\",\"farm\u00e0cia hospital\u00e0ria\",\"Investigaci\u00f3\",\"sida\",\"VIH\"],\"articleSection\":[\"M\u00f3n col\u00b7legial\"],\"inLanguage\":\"ca\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/novaorg.cofb.net\/2016\/04\/01\/quines-novetats-hi-ha-en-el-tractament-del-vih\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/novaorg.cofb.net\/2016\/04\/01\/quines-novetats-hi-ha-en-el-tractament-del-vih\/\",\"url\":\"https:\/\/novaorg.cofb.net\/2016\/04\/01\/quines-novetats-hi-ha-en-el-tractament-del-vih\/\",\"name\":\"Quines novetats hi ha en el tractament del VIH? 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