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After the first case reports of AIDS were described in 1981, it soon became clear that the epidemic constituted a public health emergency. Although the first antiretrovirals were evaluated in clinical trials in the 1980s, it was not until the mid-1990s that the clinical efficacy of combination antiretroviral chemotherapy was demonstrated to prevent immunocompromise and to restore health to people living with AIDS. When the International Antiviral Society–USA (IAS-USA) published its first antiretroviral guidelines in JAMA in conjunction with the International AIDS Conference in Vancouver in 1996,1 it represented the beginning of a new era, suggesting that the pandemic might be controlled by treatment. In the current issue of JAMA, the IAS-USA presents its most recent set of guidelines,2 reflecting substantial changes over the past 20 years in the development of more potent combinations of drugs with fewer adverse effects, the advent of coformulated medications, and the evidence that antiretroviral agents have a vital role in HIV prevention.
Mayer KH, Krakower DS. Antiretrovirals for HIV Treatment and PreventionThe Challenges of Success. JAMA. 2016;316(2):151-153. doi:10.1001/jama.2016.8902