This rapid virus production throughout the asymptomatic phase of HIV has two major implications. An antiviral therapy, which is able to stop virus production, will have a profound effect on disease progression. The potential for virus resistance creates a formidable challenge. These factors lead to the conclusion that antiviral therapies, that give only partial control of HIV replication, are doomed to eventual failure. Rational drug combinations Consider both targeting the same viral enzyme with 2 drugs and targeting different viral enzymes.
Triple therapy can give dramatic reduction in viral load for more than one year.
Continuous viral suppression, giving full 24 hour cover every day, is essential. Virus load as a prognostic factor. However, CD 4 cell count is an independent prognostic factor. The speed of the train represents the viral load, the distance from the rocks represents the CD 4 cell count. Complete eradication of HIV unlikely, but avoiding progression to AIDS for prolonged time with continuous therapy is becoming a real possibility.