Routine care of people with HIV infection and AIDS: should interested general practitioners take the lead?

People with HIV and AIDS in the developed world are living longer and healthier lives following the introduction of highly active antiretroviral therapy. The medical management of stable HIV infection could eventually fit into the more normal pattern of chronic disease management in the United Kingdom (UK). Routine monitoring of many chronic conditions is generally regarded as primary care business in partnership with secondary care. The latter service should be reserved for what it does best: periodic review, in-depth assessment, major changes in medication, management of complex or refractory cases, and inpatient care. We look at some of the issues and the arguments for and against any change from the current position in the UK, where almost all HIV infection is managed medically by specialist clinics in secondary and tertiary care.