Starting Highly Active Antiretroviral Therapy for HIV Infection: Is It WIHS To Wait?
Authors: Robert T. Schooley
Journal: Annals of Internal Medicine (2004)

Editorials17 February 2004Starting Highly Active Antiretroviral Therapy for HIV Infection: Is It WIHS To Wait?Robert T. Schooley, MDRobert T. Schooley, MDFrom University of Colorado Health Sciences Center; Denver, CO 80262.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-4-200402170-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Since the advent of combination antiretroviral chemotherapy in 1995, we have witnessed one of the most remarkable reversals of fortune in any disease in the history of medicine. In 1984, the median survival for HIV-1–infected persons with Pneumocystis carinii pneumonia was about 6 months; it is now closer to 10 years and might be longer. Nonetheless, it is clear that therapy causes toxicity in some patients and leads to economic costs in all patients. These issues have appropriately triggered discussions about how to individualize therapy to maximize benefit, minimize toxicity, and reduce financial costs to society.In this issue, Anastos ...References1. Anastos K, Barrón Y, Cohen MH, Greenblatt RM, Minkoff H, Levine A, et al . The prognostic importance of changes in CD4+ cell count and HIV-1 RNA level in women after initiating highly active antiretroviral therapy. Ann Intern Med. 2004;140:256-64. LinkGoogle Scholar2. Hogg RS, Yip B, Chan KJ, Wood E, Craib KJ, O'Shaughnessy MV, et al . Rates of disease progression by baseline CD4 cell count and viral load after initiating triple-drug therapy. JAMA. 2001;286:2568-77. [PMID: 11722271] CrossrefMedlineGoogle Scholar3. Egger M, May M, Chene G, Phillips AN, Ledergerber B, Dabis F, et al . Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies. Lancet. 2002;360:119-29. [PMID: 12126821] CrossrefMedlineGoogle Scholar4. Wood E, Hogg RS, Yip B, Harrigan PR, O'Shaughnessy MV, Montaner JS. 2003 Effect of medication adherence on survival of HIV-infected adults who start highly active antiretroviral therapy when the CD4+ cell count is 0.200 to 0.350 × 109 cells/L. Ann Intern Med. 139:810-6. [PMID: 14623618] LinkGoogle Scholar5. Friis-Moller N, Sabin CA, Weber R, d'Arminio Monforte A, El-Sadr WM, Reiss P, et al . Combination antiretroviral therapy and the risk of myocardial infarction. N Engl J Med. 2003;349:1993-2003. [PMID: 14627784] CrossrefMedlineGoogle Scholar6. Dube MP, Stein JH, Aberg JA, Fichtenbaum CJ, Gerber JG, Tashima KT, et al . Guidelines for the evaluation and management of dyslipidemia in human immunodeficiency virus (HIV)-infected adults receiving antiretroviral therapy: recommendations of the HIV Medical Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group. Clin Infect Dis. 2003;37:613-27. [PMID: 12942391] MedlineGoogle Scholar7. Lichtenstein KA, Delaney KM, Armon C, Ward DJ, Moorman AC, Wood KC, et al . Incidence of and risk factors for lipoatrophy (abnormal fat loss) in ambulatory HIV-1-infected patients. J Acquir Immune Defic Syndr. 2003;32:48-56. [PMID: 12514413] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Robert T. Schooley, MDAffiliations: From University of Colorado Health Sciences Center; Denver, CO 80262.Disclosures:Consultancies and Honoraria: Bristol Myers-Squibb, GlaxoSmithKline, Merck, Pfizer, Roche, Vertex, ViroLogic, Tanox, Gilead; Stock ownership or options (other than mutual funds): ViroLogic, Tanox, Vertex; Grants received: Merck, Tanox; Grants pending: Pfizer, Tibotec.Corresponding Author: Robert T. Schooley, MD, Division of Infectious Diseases, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, B-168, Denver, CO 80262; e-mail, Robert.Schooley@UCHSC.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Prognostic Importance of Changes in CD4+ Cell Count and HIV-1 RNA Level in Women after Initiating Highly Active Antiretroviral Therapy Kathryn Anastos , Yolanda Barrón , Mardge H. Cohen , Ruth M. Greenblatt , Howard Minkoff , Alexandra Levine , Mary Young , and Stephen J. Gange Metrics 17 February 2004Volume 140, Issue 4Page: 305-306KeywordsAntiretroviral therapyAntiretroviralsCardiovascular therapyChemotherapyCohort studiesDrug therapyDrugsHIVHIV infectionsTreatment guidelines ePublished: 17 February 2004 Issue Published: 17 February 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...