Long-term therapeutic strategies in HIV

Advances in the management of human immunodeficiency virus (HIV) disease, including the use of potent combination antiretroviral regimens, has greatly improved the outlook for patients with AIDS. Because HIV patients can now survive for extended periods, clinicians need to develop rational plans for long-term therapy that recognize the impact of such therapy on the patient. There are many similarities between cancer and HIV disease and an oncologic model can be used to design treatment plans for HIV. A successful plan for long-term management of HIV involves establishing the diagnosis and extent of disease; determining the concerns of the patient as they relate to specific life goals and quality-of-life issues; identifying antiretroviral regimens for initial therapy, salvage therapy, and terminal or experimental therapy; and implementing the plan using clear parameters to evaluate the response to therapy. Tremendous strides have been made in managing HIV disease. It is now time to advance our management of the patients' concerns.