The eleventh international conference on AIDS: cautious celebration in Vancouver

For the first time in the short but turbulent history of the International Conference on AIDS (acquired immune deficiency syndrome), participants found themselves in the midst of a sea change in the treatment of human immunodeficiency virus (HIV) disease. Scientists, health policy experts, politicians, and AIDS activists alike shared the anticipation. Report after report heralded improved outcomes in patients receiving combination therapy rather than monotherapy with reverse transcriptase inhibitors, particularly when investigators combined these agents with newly available protease inhibitors. The drug combinations dramatically reduced viral load in plasma, in some cases to undetectable levels, resulting in sharp rebounds in immune function. Even more encouraging is the pipeline for new and possibly more effective strategies. The cost of the new therapy for HIV disease, however, will limit the benefit to no more than 10% of the world's population infected with the virus.