October 15, 1997

Issues Regarding Antiretroviral Treatment for Patients With HIV-1 Infection-Reply

Author Affiliations

for the International AIDS Society-USA Panel Brown University School of Medicine Providence, RI

JAMA. 1997;278(15):1235. doi:10.1001/jama.1997.03550150039029

In Reply.  —We appreciate the comments from Drs Ickowics and Chesney, Frenkel and Melvin, and Fischer with regard to our consensus recommendations for antiretroviral therapy in HIV infection in adults. We concur with the need for prospectively designed adherence assessments during controlled clinical trials of antiretroviral drugs and fully agree that such trials provide a unique opportunity (and a compelling mandate) to carry out interdisciplinary investigations that will enhance clinical practice. The recommendations of our panel are directed toward HIV infection in adults and, as Frenkel and Melvin discuss, there remains an urgent need to conduct detailed studies of potent antiretroviral regimens in infants and in young children. We concur with Fischer's comments with regard to antiretroviral therapy for HIV-infected pregnant women; the US Public Health Service has recently released draft guidelines that provide more specific recommendations for aggressive antiretroviral therapy in this setting,11 which are available from the National