Third International Congress Drug Therapy in HIV Infection 3-7 November 1996 Glasgow, UK

ANTIRETROVIRAL THERAPY STATE-OF-THE-ART: REVIEW AND RECOMMENDATIONS

Steven M. Schnittman
Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 6003 Executive Blvd., Rockville, MD, USA 20852

Int Cong Drug Therapy HIV 1996 Nov 3-7;3:Abstract No. 2.1
AIDS 1996, Vol. 10 (Suppl. 2);S1

Critical advances in understanding the pathogenesis and treatment of HIV infection over the last two years include delineating the replication kinetics of HIV in all stages of disease, development of assays to determine viral load in infected individuals, the availability of potent new antiretroviral drugs, and the demonstration of the efficacy of combination therapy. In light of these advances, several "state-of-the-art" panels during 1996 have developed recommendations for antiretroviral therapy for HIV disease, including the International AIDS Society international panel. The principal questions addressed include the following: when should therapy be initiated?; which types of drugs/combinations should be used?; when should therapy be changed?; and which types of drugs/combinations should be used when a change in therapy is indicated? In addition, several other important areas have been addressed including the treatment of primary HIV-1 infection, prevention of neonatal transmission, and post-exposure chemoprophylaxis. The preferred initial treatment regimens include nucleoside combinations, adding a protease inhibitor for those patients at greatest risk for disease progression, i.e. those with relatively higher HIV RNA viral loads. Treatment failure, which may include evidence of increased viral replication, declining CD4+ T-cell counts, or clinical progression, should point to consideration of changing to at least two new drugs. The development of clinical guidelines for HIV therapy today requires a multi-faceted approach including evaluation of controlled clinical trials with clinical endpoints, trials assessing virologic and immunologic endpoint data of all available antiretroviral drugs, as well as extensions of our understanding of the pathogenesis of HIV-1 infection.

Presenting author: Steven M. Schnittman

1996-11-03
2.1

Originally published in AIDS Volume 10, Supplement 2 and hosted with permission of the publisher Lippincott Williams & Wilkins, 250 Waterloo Road, London, SE1 8RD, UK. Tel: +44 (0)20 7981 0700 Fax: +44 (0) 7981 0701

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