HIV/AIDS management in office practice. Antiretroviral therapy

Treatment of HIV with nucleoside analog reverse transcriptase inhibitors (RTIs) and protease inhibitors forms the backbone of anti-HIV therapy. Non-nucleoside RTIs, immune modulators, and new entries in existing classes of pharmacologic agents hold promise for the future. Combination therapy with two, three, or more agents has become the standard of care, although additive toxicities often can be dose-limiting. Increases in the understanding of viral dynamics have introduced measures of systemic viral burden into clinical practice, and viral load considered in combination with CD4 lymphocyte numbers guides decisions about initiating and modifying antiviral therapy.