Martin Markowitz, MD

As treatments for HIV-1 infection have become more effective, better tolerated, and more conveniently administered, treatment success has increased, but many factors influence treatment response. In addition to issues concerning when to initiate HAART and how to optimize therapeutic potency, challenges related to resistance to antiretroviral therapy in treatment-experienced patients as well as patient demographics and adherence affect antiviral response. [Infect Med. 2008;25:294-298]

The effective management of HIV-1 infection has evolveddramatically over the past decade. As treatments have becomemore effective, better tolerated, and easier to take, treatmentsuccess as defined by surrogate markers has becomeincreasingly common. Nevertheless, responses to therapyare not uniform, and even in the ideal setting of clinical trialswith a select patient population treated with a compact andwell-tolerated regimen, sustained antiviral response will not beachieved in up to 20% of patients. Major factors that influencetreatment response include adherence, stage of disease at whichtherapy is initiated, therapeutic potency, patient demographics,and treatment history. In the first part of this 2-part series, stageof disease and therapeutic potency are addressed. [Infect Med.2008;25:222-226]