[AIDS; new developments. II. Treatment of HIV infection]

The currently available anti-HIV drugs can be subdivided according to the mechanisms of action into two main groups, viz, reverse transcriptase (RT) inhibitors and protease inhibitors; the former may be subdivided into nucleoside inhibitors and non-nucleoside inhibitors of reverse transcriptase. Combination therapy is preferable to monotherapy because of resistance problems. The 'ideal' combination consists of two RT inhibitors plus one protease inhibitor. Of the RT inhibitors, zidovudine is to be preferred because it slows the development of AIDS dementia. Other RT inhibitors are didanosine, zalcitabine, stavudine and lamivudine. As regards the protease inhibitors; in view of the development of resistance, it is advised to prescribe ritonavir, indinavir or saquinavir. The antiretroviral management should be adjusted as soon as signs appear of toxicity or failure of the treatment due to resistance or poor compliance.