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What hath HAART wrought? Or the social contract.


 Presentations at the 12th World AIDS Conference in Geneva examined the legacy and future of highly active antiretroviral therapy (HAART). Conference attendees revealed that the cache of memory T cells does dwindle in some HAART-treated persons, that HAART can continue to increase CD4+ counts for 2 years or more, that eradication may not be necessary, that understanding immune system rebounding following the start of HAART is elusive, and that getting treatment-naive people into sub-50-copy viral loads at any cost may not be all that realistic or desirable. Conference attendees also explored what constitutes HAART failure, issues of when to start antiretroviral and salvage therapies, the value of resistance testing, which regimens are the best, lipodystrophy treatment management, and preliminary data from three new protease inhibitors: amprenavir, ABT-378, and tipranavir. Final discussions examined the supply and availability of AIDS drugs to the untreated populations of the world.
