Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- 98 HIV infection: initial evaluation and monitoring
- 99 HIV infection: antiretroviral therapy
- 100 Immune reconstitution inflammatory syndrome (IRIS)
- 101 Differential diagnosis and management of HIV-associated opportunistic infections
- 102 Prophylaxis of opportunistic infections in HIV disease
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
99 - HIV infection: antiretroviral therapy
from Part XII - HIV
Published online by Cambridge University Press: 05 April 2015
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- 98 HIV infection: initial evaluation and monitoring
- 99 HIV infection: antiretroviral therapy
- 100 Immune reconstitution inflammatory syndrome (IRIS)
- 101 Differential diagnosis and management of HIV-associated opportunistic infections
- 102 Prophylaxis of opportunistic infections in HIV disease
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
Summary
Introduction
The first cases of the human immunodeficiency virus (HIV) were first described in the early 1980s, prompting an aggressive search for a cure for this deadly virus. In 1987, the approval of zidovudine, the first medication approved for the treatment of HIV, ushered in a new age in HIV management. As our understanding of HIV evolved, new therapies gradually emerged in the 1990s, as did hope that a curative medication regimen may be discovered.
Single-drug nucleoside reverse transcriptase inhibitor therapy initially conferred only 6 to 12 months of benefit to patients before viral resistance rendered this approach ineffective. Therapeutic strategy then evolved into dual-drug therapy, which extended benefit to 2 to 3 years. Eventually the use of a three-drug regimen (i.e., highly active antiretroviral therapy, or HAART) in the mid 1990s became the predominant regimen and remains the standard of care today.
Along with these new drug developments came new frustrations, however, manifested as mutated and resistant HIV strains, high pill burdens, and significant toxicities. These multi-drug regimens subsequently have been refined over the past 10 years, to the point where many patients are able to maintain an intact immune system with no detectable virus on single-pill, triple-drug coformulated, minimally toxic antiretroviral therapy (ART) regimens. While the goal of HIV eradication has remained elusive, the modern age of ART has commonly rendered HIV disease a chronic condition that, when ideally managed, can lead to a reasonable life expectancy in patients who once considered this infection a death sentence.
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- Information
- Clinical Infectious Disease , pp. 645 - 668Publisher: Cambridge University PressPrint publication year: 2015