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November 13, 2009

New Paradigms of First-Line HIV Therapy: Determining When (and With What) to Start

"The cohorts alone probably wouldn't be sufficient to drive dramatic changes in clinical practice, but it's coming along with the fact that we have so many antiretroviral treatment options that are currently very well tolerated, with extremely high levels of efficacy, relatively low levels of toxicity and low levels of resistance, and many other options. So even if resistance were to develop, we'd still be able to successfully treat patients.

"We took the small, randomized control trial, dramatic changes in the types of therapies that are available for our patients and then built on top of that.

"One other major observation has come out over the last several years with respect to this relationship between ongoing viremia and high levels of immune activation and inflammation, and how this might affect other end organs -- other than things like the immune system -- such as endothelial function, which can have an impact on cardiovascular disease and renal disease.

"And that is that, with all of this, there's an increasing case being built, even in the absence of a large, randomized control trial, for perhaps recommending antiretroviral therapy to virtually every HIV-infected patient who, importantly, is ready, willing and able to commit to treatment."

Read more in The Body Pro, November 11, 2009.