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July 2004

AIDS and Ophthalmology in 2004

Arch Ophthalmol. 2004;122(7):1040-1042. doi:10.1001/archopht.122.7.1040

Since the introduction of highly active antiretroviral therapy (HAART)in 1996, there has been a dramatic change in the AIDS epidemic in industrializednations.1 Highly active antiretroviral therapyconsists of combination antiretroviral therapy, typically with 3 or more drugs,and generally includes either a protease inhibitor or a nonnucleoside reversetranscriptase inhibitor. By suppressing human immunodeficiency virus (HIV)replication for sustained periods of time, HAART can lead to improvementsin immune function (immune recovery) and restoration of immunity to specificpathogens.2 As a consequence, the incidenceof opportunistic infections has declined, as has the mortality associatedwith AIDS,1 resulting in an increased prevalenceof patients alive with AIDS. If there is sufficient sustained immune recovery,secondary prophylaxis ("maintenance therapy"), such as those for Pneumocystis carinii pneumonia and cytomegalovirus (CMV) retinitis,can be discontinued without relapse of the disease.3,4

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