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February 26, 1997

The Art of 'HAART': Researchers Probe the Potential and Limits of Aggressive HIV Treatments

JAMA. 1997;277(8):614-616. doi:10.1001/jama.1997.03540320016008

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IN THE space of less than 2 years, some AIDS researchers have moved from the early flush of success with new, aggressive drug regimens that battle the human immunodeficiency virus (HIV) to cautious speculation that they may be on the right track to developing a viruseradicating strategy for at least some HIV-infected patients.

However, mindful of a roller-coaster history of dashed hopes in treating HIV infection and AIDS, many investigators point out that formidable hurdles must be cleared before such hopes can be realized. These include the familiar specter of drug resistance, toxic adverse effects and rigorous dosing regimens that make tolerance of the drugs difficult and compliance problematic, treatment histories that render some patients unsuitable candidates for the aggressive new therapies, the possibility that sanctuary sites (such as the brain) contain a reservoir of virus that is beyond the drugs' reach, and the fear that the HIV-ravaged immune systems