[Antiviral therapy of HIV infection in adults]

Great progress has been made in antiviral treatment of HIV disease over the last few years.

The paper is based on relevant literature and our own experience in the largest HIV clinic in Norway.

Generally speaking, therapy with at least three active drugs is necessary in order to obtain maximum viral suppression. It is not established what constitutes the best starting-point for therapy, or what combination of drugs is the most efficacious. Treatment should be initiated before clinical immunodeficiency develops. All patients with CD4 counts < or = 0.2 x 10(9)/l should be offered treatment. The initial regimen should be either two nucleoside-analogues and one or two protease inhibitors, or two nucleoside-analogues and efavirenz. In order to avoid resistance and treatment failure, the patient should be thoroughly informed before and during treatment about the importance of good compliance.