HIV and combination therapy: meeting the challenge of a new era

With the advent of combination therapy in the treatment of human immunodeficiency virus (HIV) infection, there has been a vast reduction in the number of people admitted to AIDS units as inpatients, and a marked improvement in the quality of life for people infected with HIV. Combination therapy comprises the combined administration of various powerful antiviral drugs to prevent CD4 cell destruction and minimize the chance of a rapidly replicating virus becoming resistant. This article presents an overview of the basic elements of this therapy, discussing some of the challenges that are a corollary of this new era. In particular, the implications of an extended period of survival and wellness for a group of people previously thought to be the victims of a strictly acute condition are addressed. These implications relate to therapeutic, psychological, employment, social and sexual issues. Finally, the issues facing carers (both lay and professional) are discussed.