Complejidad de la transición de los esquemas antirretrovirales en un programa de atención de VIH en Bogotá durante el periodo de 2015-2017

At the time of making changes in the antiretroviral therapy, future options may be limited, and this is the time when the behavior of the treatment staff should be the most appropriate. A transversal-descriptive study was conducted, studying the main causes of scheme changes in HIV patients of the IPS CEPAIN in Bogota (Colombia) during the 2015-2017 period. Treatment changes were estimated at 8.1%, 8.8% and 5.8% during the 3 years, the main reason for change were adverse reactions with 53.1%, 46% and 49.6% respectively, followed by simplification with 17.5, 25.1 and 26.5% and therapeutic failure in 19.8, 20.9 and 14.8% for each year. During the first year of treatment, there was a need to change the regimens in 12.9, 18.5, and 7.6% of the patients who started treatment in those years. Decisions on antiretroviral treatment changes involve the introduction of new antiretrovirals, reduce the number of tablets or drugs, different profiles of efficacy, tolerance, side effects, toxicity, genetic barrier and interactions. Other factors to take into account are rising cost of antiretroviral drugs, the dynamics in the transition and the application of the new schemes to ensure a clinical and sustainable economic approach.