Improved Survival Among HIV-Infected Individuals Following Initiation of Antiretroviral Therapy

Abstract

ANTIRETROVIRAL therapy has been shown to prolong survival in persons with acquired immunodeficiency syndrome (AIDS) and those with intermediate-stage human immunodeficiency virus (HIV) infection.^1-6 Between 1990 and 1995, didanosine and zalcitabine were increasingly used in combination with zidovudine. The available options for combination antiretroviral therapy expanded further when positive results were reported in clinical trials involving lamivudine and stavudine^7-9 and, more recently, in trials involving protease inhibitors and nonnucleoside reverse transcriptase inhibitors.^10-18 Recently, viral load–driven therapy has been adopted, as a growing body of evidence has established plasma viral load as a meaningful predictor of disease progression.^19-21 Overall, these developments have resulted in significant changes to the therapeutic management of this disease^22,23 and have led to a dramatic increase in the use of double- and, more recently, triple-combination antiretroviral therapy regimens among HIV-infected persons.