infectious diseases
Antiretroviral Treatment of HIV Infection
Introduction
Because disease-related complications can occur in untreated patients with high CD4 counts and because less toxic drugs have been developed, treatment with antiretroviral therapy (ART) is now recommended for all patients. The benefits of ART outweigh the risks in every patient group and setting that has been carefully studied. ART aims to Reduce the plasma HIV RNA level to undetectable (ie, < 20 to 50 copies/mL) Restore the CD4 count to a normal level (immune restoration or reconstitution) ART can usually achieve its goals if patients take their drugs>95% of the time. If treatment fails, drug susceptibility (resistance) assays can determine the susceptibility of the dominant HIV strain to all available drugs. Genotype assays may also be helpful. Many patients living with HIV infection are taking complex regimens involving multiple pills. With the availability of new co-formulated HIV drugs, many patients could benefit from simplification of their ART regimen, guided byHIV DNA archive genotype testing(GenoSure Archive). (See also Treatment in Human Immunodeficiency Virus (HIV) Infection.) 