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July 1, 1998

Treat HIV-1 Infection Like Other Infections—Treat It

Author Affiliations

From the Partners AIDS Research Center and Infectious Disease Division, Massachusetts General Hospital and Harvard Medical School, Boston, Mass.


Controversies section editor: Phil B. Fontanarosa, MD, Senior Editor.

JAMA. 1998;280(1):91-93. doi:10.1001/jama.280.1.91

TREMENDOUS ADVANCES in the development of effective antiretroviral therapy for human immunodeficiency virus 1 (HIV-1) infection have been associated with an ongoing debate regarding when to initiate antiretroviral therapy.1,2 Although the concept of delayed therapy is somewhat foreign to the field of infectious diseases, it has been supported by concerns about the long-term benefits of therapies currently available, the rigors of the currently available regimens, and the typically slow course of disease in persons with HIV-1 infection. Advances in treatment have been paralleled by recent advances in the understanding of HIV-1 pathogenesis, which provide important new insights as to how the virus is affected by immune selection pressure and why antiviral drug resistance is so prevalent. In our opinion, currently available data provide convincing arguments for initiation of therapy at the earliest possible juncture in persons who are not controlling viremia on their own.