[Current status of the treatment of HIV infection]

The antiretroviral therapeutic strategy changed in 1996, when the prognostic value of the plasma viral load and the CD4 cell counts were confirmed. Two nucleosides, plus a protease inhibitor or a non-nucleoside, are currently the initial preferred options. Viral resistance, and pharmacokinetic problems, however, have limited the efficacy of these schemes. It should be emphasized that continued use of triple drug therapy regimens have been associated with a decrease of morbidity and mortality associated to AIDS. We have analyzed the different drug combinations used in clinical trials and their results, the definition of therapeutic failure, and its consequences to control the treatment. With the currently available regimens, the virus cannot be totally eradicated from the organism and treatment should be continued for life. The combination of drugs in a single tablet, and the decrease in the number of daily intakes can help the patient with adherence, and allow for supervised treatment programs like the ones already applied with success in the treatment of tuberculosis. The use of virus resistance assays and pharmacokinetic assays will help to select the most appropriate treatment in the near future.