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Strategies of Antiretroviral Therapy in Adults

Duke University Medical Center, Durham, North Carolina, USA

Correspondence: John A. Bartlett, M.D., Duke University Medical Center, Box 3238, Durham, North Carolina 27710, USA; Telephone: 919-681-6060; Fax: 919-681-8474; e-mail: jab5{at}acpub.duke.edu

Recent progress in antiretroviral treatment has led to dramatic improvements in HIV-related morbidity and mortality. These improvements have been fostered by advances in our understanding of HIV-related pathogenesis, the use of plasma HIV RNA levels to monitor patients, and the availability of 11 licensed antiretroviral drugs, including the potent protease inhibitors. Numerous drug combinations, especially those containing three agents, can suppress plasma HIV RNA levels below the lower limit of detection in the majority of treated patients. However, the limitations of this therapeutic response—patient compliance, drug resistance, and a residual burden of chronically infected cells which are refractory to treatment—should be familiar to the oncologist.

Key Words. HIV • Treatment strategies • AIDS • Antiretroviral treatment • HIV therapy