Antiretroviral treatment of HIV infected adults

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Abstract
Introduction It has been about 10 years since the first report that three drug combination antiretroviral therapy can durably suppress HIV replication.1 Subsequent studies have confirmed that when used appropriately highly active antiretroviral therapy (see box 1) can suppress viral replication to such low levels that the virus is unable to generate drug resistance mutations. Theoretically, once this level of viral suppression is achieved, treatment should work indefinitely, and the long term risk of morbidity and morality related to HIV associated immunodeficiency becomes negligible. Experience to date suggests that lifelong suppression of HIV is feasible. This review is aimed at informing clinicians about the current management of HIV infection. Authoritative and continuously updated reviews are available on the web (for example, the US Department of Health and Human Services treatment guidelines at www.hivatis.org); this review does not attempt to exhaustively summarise the literature or to provide guidance to clinicians with expertise in HIV. Rather, I summarise those issues that are likely to confront clinicians, including clinicians who do not routinely treat people infected with HIV.