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Drug treatment of HIV and AIDS

By E. Davies, J. F. Morlese, M. Bower and A. Pozniak

The rapid changes occurring in the treatment of human immunodeficiency virus (HIV) infection mean that articles and guidelines on the subject soon become obsolete.

This article provides an overview of current practice and is divided into two parts:

  • The use of antiretroviral drugs to control viral replication
  • The treatment of HIV-associated opportunistic infections

Antiretroviral therapy

The goal of antiretroviral therapy in HIV infection is to increase the length and quality of life by improving immune function. This is achieved by reducing the amount of replicating virus to as low a level as possible, for as long as possible, in all sites where HIV-infected cells are present, thereby preventing infection of new cells and further damage to the immune system.

The amount of replicating virus in the plasma can be assayed by measuring the concentration of HIV ribonucleic acid (RNA), referred to as the viral load. In practical terms, the aim of antiretroviral therapy is to lower the viral load to a value below the level of detection of the assay used. The lower limit of detection of any of the currently available licensed assays is 50 copies per ml.

Achieving this with the currently available antiretroviral agents involves appropriate selection of combination regimens to obtain an optimal antiviral response and excellent adherence to the regimen by the patient. In addition, consideration of a plan for a salvage or second line regimen is required if initial therapy fails.

Citation: Hospital Pharmacist URI: 10996180

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