「HIV」の版間の差分

2023年9月14日 (木) 15:04時点における最新版

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General issues of Vaccine

Cold chain
Correlates of Protection
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General issues of Tropical med.

General issues of Travel med.

Epidemiology of Travel health
Last minute traveler
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Immunology

Principle of human immune system
Innate immunity
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Neutralizing antibody and its assay
Antigenic Cartography
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Epi & Stats

Basics & Definition
Epidemiology
Odds in statistics and Odds in a horse race
Collider bias
Data distribution
Statistical test
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Prediction and decision
Table-related commands in STATA
Missing data and imputation

Virus

HIV
HIV-TB co-infection
HIV-STI interaction
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COVID-19

Bivalent BA.1/BA.4-5 mRNA vaccines
Monovalent XBB-1.5 mRNA vaccine
Private archives of the initial phase of the pandemic
Private archives of lecture materials of COVID vaccine as of March 2021
厚生労働省が発出する保健行政関連の文書の読み解き方

Bacteria

Rickettsia

Rickettsiosis
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Spotted fevers
Epidemic typhus
Murine typhus

Protozoa

Overview of protozoa
Overview of medicine for protozoa
Malaria
Chagas disease
African trypanosomiasis
Leishmaniasis
Trichomoniasis
Toxoplasmosis
Amoebiasis
Giardiasis
Cryptosporidiosis
Cyclosporiasis
Isosporiasis
Pentatrichomoniasis
Microsporidiasis
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Fungi

General issues of fungi
Coccidioidomycosis
Paracoccidioidomycosis
Histoplasmosis
Talaromycosis
Blastomycosis
Sporotrichosis

Nematode (roundworm)

Nematode principles
Lympatic filariasis
Onchocerciasis
Loiasis
Microscopic differentiation of microfilariae
Strongyloidiasis
Ascariasis
Ancylostomiasis (hookworm)
Trichuriasis (whipworm)
Enterobiasis (pinworm)
Angiostrongyliasis (rat lungworm)
Dracunculiasis (Guinea worm)
Anisakiasis
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Gnathostomiasis
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Soil-transmitted helminths

Trematode (fluke, distoma)

General issues of Helminths
Trematode principles
Schistosomiasis
Clonorchiasis
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Paragonimiasis
Metagonimiasis

Cestode (tapeworm)

General issues of Helminths
Cestode principles
Diphyllobothriasis
Sparganosis
Taeniasis
Echinococcosis

Medical Zoology

Zoonosis
Insectology
Mosquitology
Acarology
Batology
Snake toxicology
Scorpion and spider toxicology
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疫学

マクロな疫学

AIDS発症はHICではPcPが最頻，LMICでは結核が最頻

ミクロな疫学

ウイルス学

細胞感染

CD4 receptorに接合attach
CCR5/CXCR4に結合　←chemokine receptor antagonist
細胞膜融合
viral RNAの逆転写（細胞質）　←RTase inhibitor;NRTI, NNRTI
proviral RNA integration（核内）　←integrase inhibitor
ウイルスタンパクのポリペプチドへの分解と再構成（細胞質）　←protease inhibitor

HIV-1 typing

Group M
- clade: A,B,C,...,K,CRFs
  - CRF=circulating recombinant forms
Group N
Group O
Group P

検査

予防

Frequent testing
Treatment as prevention; U=U
PrPE
PEP within 72 hrs
Condom

PrEP

1 pill "Truvada"
- Tenefovir + Emtricitabine
- inhibits reverse transcriptase
20 USD/month
>86% reduction
high concentration in genital issues

Administration options

daily - for anal and vaginal sex
event-based - for anal sex
≧4 doses/week - anal sex

daily PrEP

1 tablet/day
effective for anal sex 1 day after of commencement
effective for vaginal sex 7 days after of commencement

event-based PrEP

2 tabltes at 2-24 hours before anal sex + 1 tablet 24-48 hours after the sex
not effective against vaginal sex

4 doses/week

how to stop

have to continue for a certain duration after the last sex

monitoring

test renal function every 3 mo
- annually for eGFR>90 or <40y/o
check bone history including FRAX score
test HIV, hepB, Urea, Electrolytes
U/A
offer STIs screening

contraindication of PrEP

Renal dysfunction; eGFR<60
Osteoprorosis
event-based dosing is option for contraindicated people

clincal trials of PrEP

PROUD study
- 86% reduction of HIV
IMPACT study

Prevention of Mother to Child transmission (PMTCT)

Primary prevention in women of childbearing age
Voluntary counseling and testing (VCT) provided in prenatal care
ART for PMTCT

WHO Consolidated Guidelines in 2021

Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. 16 July 2021
- refer to 'Chapter 3.4 Infant prophylaxis' on pp.91 (134th as PDF)
Mother
- Urgently commence ART for all HIV-infected pregnant and post-partum women irrespective of time or viral load
All Infants
- Daily AZT+NVP from 0d to 6w
Breastfed infants of high risk
- Additional AZT+NVP or NVP alone from 6w to 12w
Breastfed infants of mother under ART
- Additional daily NVP from 6w to 12w
Replacement fed infants of mother under ART
- Additional daily NVP from 6w to 10-12w

WHO Clinical staging

WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children (2007)

Stage	1 ≈ CD4 500-	2 ≈ CD4 350-500	3 ≈ CD4 200-350	4 ≈ CD4 -200
Skin		Herpes zoster Papular pruritic eruptions Seborrheic dermatitis Fungal nail infections		Herpes simplex infection (oral, genital) > 1 month Talaromycosis (Asia only)
Oral GI tract		Angular cheilitis Oral ulcer, recurrent	Oral candidiasis Oral hairy leukoplakia (EBV-associated) Acute necrotizing ulcerative stomatitis/gingivitis/periodontitis Diarrhea > 1 month, unexplained	Esophageal candidiasis Cryptosporidiasis, chronic Isosporiasis, chronic
Respiratory		URIs, recurrent	Bacterial LRIs Pulmonary TB, pluribacillary	Severe bacterial LRIs, recurrent Pulmonary TB, paucibacillary Pneumocystis pneumonia (PcP)
Neurological				CNS toxoplamosis (Toxoplasmoma) HIV encephalopathy CNS cryptococcal infection (Cryptococcoma) Progressive multifocal leukoencephalopathy
Systemic	Asymptomatic Acute HIV infection Lymphadenopathy, persistent	Weight loss <10%, unexplained	Weight loss >10%, unexplained Fever > 1 month, unexplained Sever bacterial infections (LRI, bone/joint infections, meningitis) Anemia < 8g/dL of Hb, unexplained Thrombocytopenia < 50[math]\displaystyle{ \times }[/math]10[math]\displaystyle{ ^9 }[/math]/L, unexplained	HIV wasting syndrome Extrapulmonary TB Cytomegalovirus infection Non-typhoidal salmonellosis (NTS), recurrent Coccidioidomycosis (America only) Histoplasmosis Atypical disseminated leishmaniasis HIV-associated nephrophathy HIV-associated cardiomyopathy
Malignancy				Kaposi's sarcoma Lymphoma Cervical carcinoma HIV-associated solid tumors

Treatment

WHO｜Update of recommendations on first- and second-line antiretroviral regimens - Policy brief

The Lighthouse - A Centre for Comprehensive HIV/AIDS Treatment and Care in Malawi

HIV drug interaction checker

原則

異なる2クラスで異なる3剤によるcombination Txが必須
生涯治療

Combination

NRTI - Nucleoside reverse transcriptase inhibitor
NNRTI - Non-Nucleoside reverse transcriptase inhibitor
PI - Protease inhibitor
INI - Integrase inhibitor

NRTI + NRTI + {NNRTI or INI or PI}

scheme

NRTI Nucleoside Reverse Transcriptase Inhibitor
Tenofovir TDF	Once daily well tolerated	effective for Hep B	Renal toxicity (tubular damage) Fanconi syndrome hypophosphataemia glucosuria proteinuria Osteoporosis
Tenofovir alafenamide fumarate TAF	prodrug of tenofovir less side effects than TAF	effective for Hep B
Lamivudine 3TC	backbone for all regimens well tolerated 3TC and FTC have almost the same molecular structures	effective for Hep B
Emtricitabine FTC		effective for Hep B
Zidovudine AZT	Twice daily well tolerated the world-first anti-HIV		macrocytic anemia lipodystrophy
Abacavir ABC	in case of failure/intolerance of other NRTIs		febrile hypersensitivity with HLA-B5701 Caucasians need HLA-testing before treament

NNRTI Non-Nucleoside Reverse Transcriptase Inhibitor
Efavirenz EFV	1st choice in NNTRIs	neuropsychiatric side effects dizzyness, insomnia, nightmares, depression, psychoses rash gynecomastia 5-6% in Africa
Nevirapine NVP	not effective against HIV-2	rash to Stevens Johnson syndrome hepatic toxicity interact with rifampicin never use in HIV-TB

INI Integrase Inhibitor
Dolutegravir DTG	well tolerated	insomnia dizzyness paresthesia weight gain
Raltegravir RAL

PI Protease Inhibitor
Lopinavir-Ritonavir LPV-r	Twice daily	diarrhea metaboilc disturbance dyslipidemia impaired glucose tolerance lipodystrophy CYP3A4 interactions
Atazanavir ATV-r	Once daily	hyperbilirubinemia, jaundice interact with rifampicin

WHO Guideline 2019

WHO reference page is here

Adults and adolescents

1st line
NRTI
Tenofovir TDF
Tenofovir alafenamide fumarate TAF
Lamivudine 3TC
Zidovudine AZT
Abacavir ABC
NNRTI	INI	PI
Efavirenz EFV	Dolutegravir DTG	Lopinavir-Ritonavir LPV-r
Nevirapine NVP	Raltegravir RAL	Atazanavir ATV-r

Alternative 1st line
NRTI
Tenofovir TDF
Tenofovir alafenamide fumarate TAF
Lamivudine 3TC
Zidovudine AZT
Abacavir ABC
NNRTI	INI	PI
Efavirenz EFV 400mg	Dolutegravir DTG	Lopinavir-Ritonavir LPV-r
Nevirapine NVP	Raltegravir RAL	Atazanavir ATV-r

Special circumstances
NRTI
Tenofovir TDF
Tenofovir alafenamide fumarate TAF
Lamivudine 3TC
Zidovudine AZT
Abacavir ABC
NNRTI	INI	PI
Efavirenz EFV	Dolutegravir DTG	Lopinavir-Ritonavir LPV-r
Nevirapine NVP	Raltegravir RAL	Atazanavir ATV-r

Children

1st line
NRTI
Tenofovir TDF
Tenofovir alafenamide fumarate TAF
Lamivudine 3TC
Zidovudine AZT
Abacavir ABC
NNRTI	INI	PI
Efavirenz EFV	Dolutegravir DTG	Lopinavir-Ritonavir LPV-r
Nevirapine NVP	Raltegravir RAL	Atazanavir ATV-r

Alternative 1st line
NRTI
Tenofovir TDF
Tenofovir alafenamide fumarate TAF
Lamivudine 3TC
Zidovudine AZT
Abacavir ABC
NNRTI	INI	PI
Efavirenz EFV	Dolutegravir DTG	Lopinavir-Ritonavir LPV-r
Nevirapine NVP	Raltegravir RAL	Atazanavir ATV-r

Special circumstances
NRTI
Tenofovir TDF
Tenofovir alafenamide fumarate TAF
Lamivudine 3TC
Zidovudine AZT
Abacavir ABC
NNRTI	INI	PI
Efavirenz EFV	Dolutegravir DTG	Lopinavir-Ritonavir LPV-r
Nevirapine NVP	Raltegravir RAL	Atazanavir ATV-r

Neonates

1st line
NRTI
Tenofovir TDF
Tenofovir alafenamide fumarate TAF
Lamivudine 3TC
Zidovudine AZT
Abacavir ABC
NNRTI	INI	PI
Efavirenz EFV	Dolutegravir DTG	Lopinavir-Ritonavir LPV-r
Nevirapine NVP	Raltegravir RAL	Atazanavir ATV-r

Alternative 1st line
NRTI
Tenofovir TDF
Tenofovir alafenamide fumarate TAF
Lamivudine 3TC
Zidovudine AZT
Abacavir ABC
NNRTI	INI	PI
Efavirenz EFV	Dolutegravir DTG	Lopinavir-Ritonavir LPV-r
Nevirapine NVP	Raltegravir RAL	Atazanavir ATV-r

Special circumstances
NRTI
Tenofovir TDF
Tenofovir alafenamide fumarate TAF
Lamivudine 3TC
Zidovudine AZT
Abacavir ABC
NNRTI	INI	PI
Efavirenz EFV	Dolutegravir DTG	Lopinavir-Ritonavir LPV-r
Nevirapine NVP	Raltegravir RAL	Atazanavir ATV-r

NRTIs

Nucleoside analogue 競合的にNRTを阻害する

Tenofovir TDF 最重要
- Once daily
- hep Bにも有効
- 腎毒性；尿細管障害
  - 尿dip stickでモニター
- 骨塩減少
  - 小児には使いにくい
- Tenofovir alafenamide fumarate TAF；新しいプロドラッグ
Zidovudine AZT
- 最初のARV in 1987
- 骨髄抑制；大球性貧血
- Twice daily
Lamivudine 3TC /Emtricitabine FTC
- Lamivudine 3TC
  - すべてのレジメンでbackbone
  - high tolerance
  - hep Bにも有効
  - 耐性閾値が低い
- Emtricitabnine FTC
  - 3TCのlong-acting type
Abacavir ABC
- 他薬intolerance時の代替
  - 主として小児
- HLA-B5701陽性者でのfebrile hypersensitivity
  - HLA-B5701陽性者はアフリカでは極めて稀

NNRTIs

Efavirenz EFV
Nevirapine NVP

Efavirenz EFV
- NNRTIの1st choice
- little interaction with Tb drugs
- dizzyness, insomnia, nightmare, depression, psychoses
- rash
- gynecomastia; 6% in Africa

Nevirapine NVP
- あまり使われなくなった
- Rash→Stevens-Johnson
- 肝毒性
  - 女性に多い
  - CD4>250でリスク12倍
- HIV-2に無効
- RifampicinがNVP濃度を下げる

INIs

Dolutegravir DTG
Raltegravir RAL

very well tolerated
rapid viral suppression
lesser drug interaction
high threshold resistance

Doltegravir DTG
- 1st line としてEFVに取って代わった
- once daily
- no food interaction
- neural tube defectがわずかに増加する；妊娠可能女性では十分な説明と同意

PIs

2nd line
下痢
dyslipidemia, 耐糖能異常
lipodystrophy syndrome
CYP3A4阻害
boosting PIs；PIをごく少量の他のPI ritonavirと併用
- -rを付す
- Lopinavir-Ritonavir LPV-r
- Atazanavir ATV-r
  - 高ビリルビン血症，黄疸

WHO 1st line

TDF+3TC+DTG
TDF+3TC+EFV

WHO 2nd line

NRTI+NRTI+INI
NRTI+NRTI+PI

CPT

Co-trimoxazole preventive therapy

480-960mg/日 ST合剤

Treatment of advanced HIV

Minimum package of diagnostics for advanced HIV

IRIS

Immune reconstitution inflammatory syndrome

importance to monitor IRIS
CD4 count が低い状態で日和見感染を開始するときはARTは最低限1ヶ月空けてから
- paradoxical IRIS

フォローアップ

治療効果判定にはviral load
CD4 countは初診時には有用だがフォローアップには無用；viral loadが大事

Additional materials of HIV

Nature Materials in HIV research

https://www.nature.com/collections/mghkkdjlgx

@@ 1行目: / 1行目: @@
-{{TM menu}}
+{{Floating_Menu}}
 ==疫学==
@@ 45行目: / 45行目: @@
 #≧4 doses/week - anal sex
-===daily===
+====daily PrEP====
 *1 tablet/day
 *effective for anal sex 1 day after of commencement
 *effective for vaginal sex 7 days after of commencement
-===event-based===
+====event-based PrEP====
 *2 tabltes at 2-24 hours before anal sex + 1 tablet 24-48 hours after the sex
 *not effective against vaginal sex
-===4 doses/week===
+====4 doses/week====
-===how to stop===
+====how to stop====
 *have to continue for a certain duration after the last sex
 *
 *
-===monitoring===
+====monitoring====
 *test renal function every 3 mo
 **annually for eGFR>90 or <40y/o
@@ 69行目: / 69行目: @@
 *offer STIs screening
-===contraindication===
+====contraindication of PrEP====
 *Renal dysfunction; eGFR<60
 *Osteoprorosis
 *event-based dosing is option for contraindicated people
-===clincal trial===
+====clincal trials of PrEP====
 *PROUD study
 **86% reduction of HIV
 *IMPACT study
+===Prevention of Mother to Child transmission (PMTCT)===
+*Primary prevention in women of childbearing age
+*Voluntary counseling and testing (VCT) provided in prenatal care
+*ART for PMTCT
+====WHO Consolidated Guidelines in 2021====
+*[https://www.who.int/publications/i/item/9789240031593 Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. 16 July 2021]
+**refer to 'Chapter 3.4 Infant prophylaxis' on pp.91 (134th as PDF)
+*Mother
+**Urgently commence ART for all HIV-infected pregnant and post-partum women irrespective of time or viral load
+*All Infants
+**Daily AZT+NVP from 0d to 6w
+*Breastfed infants of high risk
+**Additional AZT+NVP or NVP alone from 6w to 12w
+*Breastfed infants of mother under ART
+**Additional daily NVP from 6w to 12w
+*Replacement fed infants of mother under ART
+**Additional daily NVP from 6w to 10-12w
+==WHO Clinical staging==
+{{quote|content=[https://apps.who.int/iris/handle/10665/43699 WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children (2007)]
+}}
+{|class="wikitable"
+|-
+!style="width:4%"|Stage
+!style="width:24%"|1<br>&asymp; CD4 500-
+!style="width:24%"|2<br>&asymp; CD4 350-500
+!style="width:24%"|3<br>&asymp; CD4 200-350
+!style="width:24%"|4<br>&asymp; CD4 -200
+|- style="vertical-align:top"
+!Skin
+|
+|
+*Herpes zoster
+*Papular pruritic eruptions
+*Seborrheic dermatitis
+*Fungal nail infections
+|
+|
+*Herpes simplex infection (oral, genital) > 1 month
+*[[Talaromycosis|Talaromycosis]] (Asia only)
+|- style="vertical-align:top"
+!Oral<br>GI tract
+|
+|
+*Angular cheilitis
+*Oral ulcer, recurrent
+|
+*'''Oral''' candidiasis
+*Oral hairy leukoplakia (EBV-associated)
+*Acute necrotizing ulcerative stomatitis/gingivitis/periodontitis
+*Diarrhea > 1 month, unexplained
+|
+*'''Esophageal''' candidiasis
+*Cryptosporidiasis, chronic
+*Isosporiasis, chronic
+|- style="vertical-align:top"
+!Respiratory
+|
+|
+*URIs, recurrent
+|
+*Bacterial LRIs
+*Pulmonary TB, '''pluribacillary'''
+|
+*Severe bacterial LRIs, recurrent
+*Pulmonary TB, '''paucibacillary'''
+*Pneumocystis pneumonia (PcP)
+|- style="vertical-align:top"
+!Neurological
+|
+|
+|
+|
+*CNS toxoplamosis (Toxoplasmoma)
+*HIV encephalopathy
+*CNS cryptococcal infection (Cryptococcoma)
+*Progressive multifocal leukoencephalopathy
+|- style="vertical-align:top"
+!Systemic
+|
+*Asymptomatic
+*Acute HIV infection
+*Lymphadenopathy, persistent
+|
+*Weight loss '''<10%''', unexplained
+|
+*Weight loss '''>10%''', unexplained
+*Fever > 1 month, unexplained
+*Sever bacterial infections (LRI, bone/joint infections, meningitis)
+*Anemia < 8g/dL of Hb, unexplained
+*Thrombocytopenia < 50<math>\times</math>10<math>^9</math>/L, unexplained
+|
+*HIV wasting syndrome
+*Extrapulmonary TB
+*Cytomegalovirus infection
+*Non-typhoidal salmonellosis (NTS), recurrent
+*[[Coccidioidomycosis|Coccidioidomycosis]] (America only)
+*[[Histoplasmosis|Histoplasmosis]]
+*Atypical disseminated leishmaniasis
+*HIV-associated nephrophathy
+*HIV-associated cardiomyopathy
+|- style="vertical-align:top"
+!Malignancy
+|
+|
+|
+|
+*Kaposi's sarcoma
+*Lymphoma
+*Cervical carcinoma
+*HIV-associated solid tumors
+|}
 ==Treatment==
@@ 258行目: / 373行目: @@
 |-
 |Efavirenz<br>EFV
-!style="background-color:yellow"|Dolutegravir<br>DTG
+!style="background-color:gold"|Dolutegravir<br>DTG
 |Lopinavir-Ritonavir<br>LPV-r
 |-
@@ 287行目: / 402行目: @@
 !style="width:33.3%"|PI
 |-
-!style="background-color:yellow"|Efavirenz<br>EFV 400mg
+!style="background-color:gold"|Efavirenz<br>EFV 400mg
 |Dolutegravir<br>DTG
 |Lopinavir-Ritonavir<br>LPV-r
@@ 340行目: / 455行目: @@
 |colspan="3"|Tenofovir alafenamide fumarate<br>TAF
 |-
-|colspan="3"|Lamivudine<br>3TC
+!colspan="3" style="background-color:khaki"|Lamivudine<br>3TC
 |-
 |colspan="3"|Zidovudine<br>AZT
 |-
-|colspan="3"|Abacavir<br>ABC
+!colspan="3" style="background-color:khaki"|Abacavir<br>ABC
 |-
 !style="width:33.3%"|NNRTI
@@ 351行目: / 466行目: @@
 |-
 |Efavirenz<br>EFV
-|Dolutegravir<br>DTG
+!style="background-color:khaki"|Dolutegravir<br>DTG
 |Lopinavir-Ritonavir<br>LPV-r
 |-
@@ 370行目: / 485行目: @@
 |colspan="3"|Tenofovir alafenamide fumarate<br>TAF
 |-
-|colspan="3"|Lamivudine<br>3TC
+!colspan="3" style="background-color:khaki"|Lamivudine<br>3TC
 |-
 |colspan="3"|Zidovudine<br>AZT
 |-
-|colspan="3"|Abacavir<br>ABC
+!colspan="3" style="background-color:khaki"|Abacavir<br>ABC
 |-
 !style="width:33.3%"|NNRTI
@@ 382行目: / 497行目: @@
 |Efavirenz<br>EFV
 |Dolutegravir<br>DTG
-|Lopinavir-Ritonavir<br>LPV-r
+!style="background-color:khaki"|Lopinavir-Ritonavir<br>LPV-r
 |-
 |Nevirapine<br>NVP
@@ 433行目: / 548行目: @@
 |colspan="3"|Tenofovir alafenamide fumarate<br>TAF
 |-
-|colspan="3"|Lamivudine<br>3TC
+!colspan="3" style="background-color:yellow"|Lamivudine<br>3TC
 |-
-|colspan="3"|Zidovudine<br>AZT
+!colspan="3" style="background-color:yellow"|Zidovudine<br>AZT
 |-
 |colspan="3"|Abacavir<br>ABC
@@ 448行目: / 563行目: @@
 |-
 |Nevirapine<br>NVP
-|Raltegravir<br>RAL
+!style="background-color:yellow"|Raltegravir<br>RAL
 |Atazanavir<br>ATV-r
 |}
@@ 463行目: / 578行目: @@
 |colspan="3"|Tenofovir alafenamide fumarate<br>TAF
 |-
-|colspan="3"|Lamivudine<br>3TC
+!colspan="3" style="background-color:yellow"|Lamivudine<br>3TC
 |-
-|colspan="3"|Zidovudine<br>AZT
+!colspan="3" style="background-color:yellow"|Zidovudine<br>AZT
 |-
 |colspan="3"|Abacavir<br>ABC
@@ 477行目: / 592行目: @@
 |Lopinavir-Ritonavir<br>LPV-r
 |-
-|Nevirapine<br>NVP
+!style="background-color:yellow"|Nevirapine<br>NVP
 |Raltegravir<br>RAL
 |Atazanavir<br>ATV-r
@@ 493行目: / 608行目: @@
 |colspan="3"|Tenofovir alafenamide fumarate<br>TAF
 |-
-|colspan="3"|Lamivudine<br>3TC
+!colspan="3" style="background-color:yellow"|Lamivudine<br>3TC
 |-
-|colspan="3"|Zidovudine<br>AZT
+!colspan="3" style="background-color:yellow"|Zidovudine<br>AZT
 |-
 |colspan="3"|Abacavir<br>ABC
@@ 505行目: / 620行目: @@
 |Efavirenz<br>EFV
 |Dolutegravir<br>DTG
-|Lopinavir-Ritonavir<br>LPV-r
+!style="background-color:yellow"|Lopinavir-Ritonavir<br>LPV-r
 |-
 |Nevirapine<br>NVP
@@ 617行目: / 732行目: @@
 *治療効果判定にはviral load
 *CD4 countは初診時には有用だがフォローアップには無用；viral loadが大事
+==Additional materials of HIV==
+{{quote
+|content=[https://www.nature.com/collections/mghkkdjlgx Nature Materials in HIV research]
+https://www.nature.com/collections/mghkkdjlgx
+}}