[AIDS; new developments. IV. Changes in primary medical care due to new possibilities of treating HIV-infected...

A combination treatment has recently become available for HIV-infected patients; it consists of two reverse transcriptase inhibitors and one protease inhibitor. This combination therapy has consequences for primary medical care as regards diagnostics, treatment, follow-up and counselling of patients with HIV and AIDS, education of patients requiring the HIV test, information of seropositive patients not yet being treated and the cooperation and task distribution between GPs and AIDS specialists. The new combination method creates new problems for patients, such as medicalization of their lives, side effects and compliance; it also affects their prospects (social reintegration, resumed occupational activity). In the medical management, the focus shifts to early start of treatment, stimulating compliance, monitoring of effect and side effects, if any, of the treatment and coping with the patients' uncertainty about durability of the effect. If the new treatment proves to be successful in the long run as well, HIV infection/AIDS will become a chronic disease, so that the needs of care and the care methods will increasingly resemble those of other chronic diseases. There will be a growing need of extramural care, leading to new requirements regarding the study of medicine and postgraduate instruction of GPs.