Current antiretroviral therapy in the treatment of HIV infection

Since the introduction of the first antiretroviral agent, zidovudine (AZT) in 1987, much progress has been made in the chemotherapy of the human immunodeficiency virus (HIV). Currently nine antiretroviral agents are approved for the treatment of individuals infected with HIV or with the acquired immune deficiency syndrome (AIDS). These medications are routinely divided into three categories: nucleoside analogues, non-nucleoside analogues, and most recently, protease inhibitors. As our knowledge of the pathogenesis of HIV increases, new antiretroviral agents become available, and advanced techniques develop to more accurately assess the degree of viral burden in an individual's blood, recommendations regarding treatment initiation and choice of antiviral agents are continually changing. The current general consensus is to "hit early" and "hit hard." Early initiation of treatment with multidrug therapy in all individuals infected with HIV is recommended by most experts with the common goal of reducing viral load to a nondetectable level. Numerous studies have shown the increased efficacy of multidrug therapy over monotherapy, however trials are still continuing to determine combination therapies which will provide the maximum benefit.