Hoffmann Rockstroh | Hoffmann| Rockstroh HIV 2012/2013 Hoffmann| Rockstroh HIV 2012/2013 HIV 2012/2013 www.hivbook.com www.hivbook.com When should HAART be started? How can a failing drug regimen be improved? What new drugs can we expect over the next few years? What are the options for patients with lipodystrophy syndrome? How to treat children or coinfected patients? To answer these and many more questions, HIV physicians need to be constantly updating themselves.“HIV 2012/2013” will help them – with clear-cut recommendations for everyday practice. This textbook will be updated every year and is available at www.hivbook.com. Previous issues are available in several languages – Spanish, Romanian, Russian, Portuguese, Vietnamese and Persian. Again, with minimal conditions, the editors and the authors of this book agree to remove the copyright onHIV 2012/2013 for Medizin Fokus Verlag all languages except English and German. You can translate the content ofHIV 2012/2013 into any language and publish it in your own name, without paying any licensing fee. For more details, please send us an email at [email protected] 45,– Euro ISBN 978-3-941727 -11-3 Medizin Fokus Verlag With an unrestricted grant from Boehringer-Ingelheim By Marcus Altfeld, Boston (USA) Georg Behrens, Hannover Patrick Braun, Aachen U. Fritz Bredeek, San Francisco (USA) Thomas Buhk, Hamburg Rob Camp, Barcelona (Spain/USA) Christian Eggers, Linz (Austria) Stefan Esser, Essen Gerd Fätkenheuer, Cologne Andrea Gori, Milan (Italy) Thomas Harrer, Erlangen Christian Herzmann, Borstel Christian Hoffmann, Hamburg Heinz-August Horst, Kiel Martin Hower, Dortmund Peter Krings, Essen Christoph Lange, Borstel Thore Lorenzen, Hamburg Christoph Mayr, Berlin Giovanni Battista Migliori, Tradate (Italy) Till Neumann, Essen Tim Niehues, Krefeld Christian Noah, Hamburg Falk Ochsendorf, Frankfurt Ramona Pauli, Munich Mario Ostrowski, Toronto (Canada) Ansgar Rieke, Koblenz Jürgen Rockstroh, Bonn Thorsten Rosenkranz, Hamburg Andrea Rubbert-Roth, Cologne Bernhard Schaaf, Dortmund Christiane Schieferstein-Knauer, Frankfurt Reinhold E. Schmidt, Hannover Helmut Schöfer, Frankfurt Ulrike Sonnenberg-Schwan, Munich Matthias Stoll, Hannover Hendrick Streeck, Boston (USA) Jan Thoden, Freiburg Nils Venhoff, Freiburg Mechthild Vocks-Hauck, Berlin Ulrich A. Walker, Basel (Switzerland) Jan-Christian Wasmuth, Bonn Michael Weigel, Schweinfurt Thomas Weitzel, Santiago (Chile) Eva Wolf, Munich HIV 2012/2013 www.hivbook.com Edited by Christian Hoffmann and Jürgen K. Rockstroh Medizin Fokus Verlag IV Editors Christian Hoffmann, M.D., Ph.D. ICH Mitte (Infektionsmedizinisches Centrum Hamburg) Dammtorstrasse 27 20354 Hamburg, Germany Phone: + 49 40 63607963 Fax: + 49 40 63607964 email: [email protected] Jürgen K. Rockstroh, M.D., Ph.D. Department of Medicine I University of Bonn Sigmund-Freud-Strasse 25 53105 Bonn, Germany Phone: + 49 228 287 6558 Fax: + 49 228 287 5034 email: [email protected] HIV Medicine is an ever-changing field. The editors and authors of HIV 2012/13 have made every effort to provide information that is accurate and complete as of the date of publication. However, in view of the rapid changes occurring in HIV medical science, HIV prevention and policy, as well as the possibility of human error, this site may contain technical inaccuracies, typographical or other errors. Readers are advised to check the product information currently provided by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and contraindications. It is the responsibility of the treating physician who relies on experience and knowledge about the patient to determine dosages and the best treatment for the patient. The information c ontained herein is provided "as is" and without warranty of any kind. The contributors to this site, including the editors and the Medizin Fokus Verlag, disclaim responsibility for any errors or omissions or for results obtained from the use of information contained herein. © 2012 by Medizin Fokus Verlag, Hamburg Layout and Printing: Schröders Agentur, Vopeliuspfad 6, 14169 Berlin Pictogram: Tobias Emskoetter, Hamburg ISBN: 978-3-941727-11-3 V Preface 2012/2013 The goal remains the same – to make a textbook that is easily readable and can be used in the daily practice of HIV treatment. As in previous years, all the chapters of HIV 2012/2013 have been thoroughly revised. Again, special emphasis was put on actuality. This is underlined by the fact that in the antiretroviral therapy chapter alone, more than 200 are dated in the years 2011 and 2012. Previous issues of the progenitor “HIV Medicine” were available in several languages, such as Spanish, Romanian, Portuguese, Vietnamese and Persian. There have been a Russian issue in 2011. Under certain conditions, the editors and the authors of this book may agree to remove the copyright on HIV 2012/2013 for all languages except English and German. You could therefore translate the content of this book into any language and publish it under your own name, without paying a license fee. HIV 2012/2013 is also freely available on the Internet (www.hivbook.com), because we firmly believe that this is the way medical textbooks should be handled in the 21st century. Research, knowledge, and expertise in the field of HIV can be shared and accessible to those who are dedicated to the treatment and care of individuals affected by HIV. Christian Hoffmann, Jürgen K. Rockstroh Hamburg, Bonn – September 2012 Acknowledgments We would like to thank all the authors and all the people who helped us generously to realise this project, especially Laura Belkien, Nicole Bentrup, Daniel D. Breitenstein, Rob Camp, Christian Dedek, Fiona Diekhoff, Beate Doebrich, Sabine Dransfeld, Tobias Emskoetter, Thomas Fischer, André Gaidies, Fiona Gordon-Pietz, Georg Haerter, Iren Güler, Johannes Jongen, Rainer A. Jordan, Brigitte Jung, Anja Keimes, Claudia Kröger, Giao Le, Laura- Sophie Nielsen, Daniela Otto, Britta Ranneberg, Marlene Rodrigues Pereira, Sven Schellberg, Gerald Schröder, Armin Schuster, Maxie Sinner, Victor Stanislevskiy, Hans-Jürgen Stellbrink, and Martin Vogel VI Assistant Editors Rob Camp (Barcelona, Spain) Fiona Diekhoff (Hamburg, Germany) Contributors Marcus Altfeld, MD, PhD Rob Camp Partners AIDS Research Center Phone: +34 93 218 6400 Massachusetts General Hospital [email protected] Bldg. 149, 13th Street, 5th floor Christian Eggers, MD, PhD Charlestown, MA 02129 Abteilung für Neurologie USA Krankenhaus der Barmherzigen Brüder, Phone: +1 617 724 2461 Seilerstätte 2 Fax: +1 617 724 8586 A-4021 Linz [email protected] Phone: +43 732 7897 25305 [email protected] Georg Behrens, MD, PhD Klinische Immunologie Stefan Esser, MD Zentrum Innere Medizin der Department of Dermatology Medizinischen Hochschule University of Essen Carl-Neuberg-Straße 1 Hufelandstrasse 55 D-30625 Hannover D-45122 Essen Phone: +49 511 532 5393 Phone: +49 201-723-3878 Fax: +49 511 532 9067 [email protected] Gerd Fätkenheuer, MD, PhD Patrick Braun Department of Internal Medicine PZB Aachen University of Cologne Blondelstrasse 9 Joseph-Stelzmann-Str. 9 D-52062 Aachen D-50924 Köln Phone: +49 241 470970 [email protected] Fax: +49 241-408652 [email protected] Carole Gilling-Smith, MA, FRCOG, PhD Assisted Conception Unit U. Fritz Bredeek, MD, PhD Chelsea & Westminster Hospital Metropolis Medical PC 369 Fulham Road 2351 Clay Street, Suite 512 GB-London SW10 9NH San Francisco, CA 94115 Phone: +41 20 8746 8922 Phone: +1 415 292-5477 [email protected] Fax: +1 415 292-5490 Andrea Gori, MD Division of Infectious Diseases Thomas Buhk, MD San Gerado Hospital ICH Grindel University Milan-Bicocca Grindelallee 35 Via Pergolesi 33 D-20146 Hamburg IT-20052-Monza Phone: +49 40 41 32 420 Phone: +39 039 233 9310 [email protected] [email protected] Contributors VII Thomas Harrer, MD, PhD Thore Lorenzen, MD Department of Internal Medicine III ifi Institute IUniversitätsklinikum Erlangen Lohmühlenstrasse 5 Krankenhausstraße 12 D-20099 Hamburg D-91054 Erlangen Phone: +49 40 181885 3780 Phone: 49 9131 854 3004 Fax: +49 40 181885 3788 Fax: 49 9131 853 4749 [email protected] [email protected] Christoph Mayr, MD Christian Herzmann, MD MVZ Ärzteforum Seestrasse Clinical Infectious Diseases, Seestrasse 64 Medical Clinic, Research Center Borstel D-13347 Berlin Parkallee 35 Phone: +49 30 455095 0 D-23845 Borstel Fax: +49 30 455095 25 Phone: +49 4537 188 0 [email protected] Giovanni Battista Migliori, MD WHO Collaborating Center for TB and Heinz-August Horst, MD, PhD Lung Diseases University of Kiel, UKSH Fondazione S. Maugeri II. Medical Department Care and Research Institute Chemnitzstraße 33 Via Roncaccio 16 D-24116 Kiel IT-21049 Tradate Phone: +49 431-1697-1207 Phone: +39 0331 829404 Fax: +39 0331 829404 [email protected] Martin Hower Medizinische Klinik Nord Till Neumann, MD Klinikum Dortmund GmbH Universitätsklinikum Essen Hövelstrasse 8 (Gebäude Gesundheitsamt) Klinik für Kardiologie D-44137 Dortmund Hufelandstr. 55 Phone: +49 231-95320 700 D-45122 Essen Fax: +49 231-95320 702 Phone: +49 201 723 4878 [email protected] Fax: +49 201 723 5401 [email protected] Peter Krings, MD Department of Cardiology Tim Niehues, MD, PhD University of Essen Immunodeficiency and Pediatric Hufelandstr. 55 Rheumatology Centre D-45122 Essen Helios Klinikum Krefeld Phone: 49 201-723 85679 Lutherplatz 40 Fax: 49 201-723 5401 D-47805 Krefeld [email protected]