Treatment of HIV-1 infection: is it time to hit early again?

摘要

Highly active antiretroviral therapy (HAART) for the treatment of HIV-1 infection has dramatically reduced morbidity and mortality [1,2]. Triple combination therapy including a protease inhibitor was introduced widely in 1996 and, since then, numerous studies have demonstrated a clear survival benefit if patients were treated when they had CD4+ T-cell counts of fewer than 200/ul, or severe symptoms. At the same time, basic research revealed that the lentivirus HIV-l induces a massive turnover of viral particles and CD4+ target cells [3]. Availability of effective therapy and knowledge about viral pathogenesis led to the 'hit-hard and hit-early' treatment approach [4].