Highly active antiretroviral therapy (HAART) has thus far failed to
fulfill the great hope of eradicating human immunodeficiency virus 1 (HIV-1).1,2 Not only does a reservoir of long-lived
latently infected cells appear to persist for years despite apparent complete
viral suppression, but as the study by Dornadula et al3
reported in this issue of THE JOURNAL shows, continuing low-level viral replication
is likely to be occurring in most persons with HIV-1 apparently suppressed
with HAART. However, a second article in this issue by Whitcup et al4 indicates that despite the apparent failure of HAART
to completely control viral replication, current regimens lead to meaningful
immune reconstitution and have a substantial beneficial effect on an opportunistic
pathogen that only recently had been one of the most difficult to manage with
chemotherapy directed against it.
D'Aquila R, Walker B. Exploring the Benefits and Limits of Highly Active Antiretroviral Therapy. JAMA. 1999;282(17):1668–1669. doi:10.1001/jama.282.17.1668
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