Abstract
There are no clinical trials that define the optimal time to begin treatment for HIV-1 infection, nor is there data defining the best initial treatment. The expected benefits of early effective treatment are a maximal reduction of viral replication leading to immunologic restoration, slowed disease progression, longer survival and reduced disability. Current combination regimens of reverse transcriptase and protease inhibitors appear to be achieving many of these goals, at least in the short term. However, there are potential drawbacks to early therapy. Early therapy may limit the availability of effective treatments in the late stages of HIV infection when there is a high risk of disease progression. Early therapy may also lead to resistant strains of HIV; in addition to being a significant public health risk through transmission to others,1 these strains vitiate the efficacy of antiretroviral drug regimens. Further, antiretroviral chemotherapy is expensive, and is associated with both recognized and as-yet-unrecognized adverse reactions, drawbacks which may become particularly significant with long-term therapy.
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Kahn, J.O. (1999). Initial Treatment for HIV Infection. In: Mills, J., Volberding, P.A., Corey, L. (eds) Antiviral Chemotherapy 5. Advances in Experimental Medicine and Biology, vol 458. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-4743-3_22
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DOI: https://doi.org/10.1007/978-1-4615-4743-3_22
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