Issue: 2004 > December > review

Antiretroviral therapy in previously untreated adults infected with the human immunodeficiency virus type 1: established and potential determinants of virological outcome

S.H. Lowe, J.M. Prins, J.M.A. Lange


The aim of highly active antiretroviral therapy (HAART)
for patients chronically infected with the human immunodeficiency virus type 1 is to achieve maximal and durable viral suppression. Maintaining the blood plasma HIV-1-RNA concentration (pVL) <50 copies/ml is currently considered appropriate for this goal. With the current treatment options, the percentage of previously untreated patients who achieve a pVL <50 copies/ml after one year of initial HAART is about 70%. Characteristics of the host, virus, drugs and the treatment team have been associated with the virological response to initial HAART. Adjusting the initial HAART regimen and patient management to a risk profile based on these factors is possibly helpful in improving the virological response to HAART. Adherence
to a potent and well-tolerated HAART regimen is likely to
be the most relevant factor for virological success. The
additive value of the other factors needs to be clarified.