SUMMARY OF TRACK B - CLINICAL SCIENCE

Aim: To review Track B on clinical science. Major topics covered were quantitative HIV-1 plasma RNA measurement, combination antiretroviral therapy, protease inhibitors, treatment of primary HIV-1 infection, HI V-1 drug resistance, future use of antiretroviral drugs, paediatric HI V-1 infection, opportunistic infections and HIV/AIDS in developing cou ntries. Quantitative HIV-1 plasma RNA measurement: Quantification of H IV-1 RNA is a predictor of progression of immune deficiency and death in HIV-infected adults and children, and is useful in monitoring respo nse to antiretroviral therapy. Therapy: Combination antiretroviral the rapy is now the standard of care, although questions about optimal sta rting time and the best initial regimen remain unresolved. Protease in hibitors are a powerful new class of antiretroviral agents which in co mbination with other drugs can produce profound reductions in plasma H IV-1 RNA levels. Trials are in progress of combination antiretroviral therapy, including protease inhibitors, in persons recently infected w ith HIV-1 to assess the feasibility of permanent suppression or eradic ation of HIV-1. Adherence to therapy and drug resistence will become i ncreasingly important subjects. Conclusions: The genuine improvements in patient management are out of reach to the majority of the world's HIV-infected persons, a conclusion with implications which dampened th e optimism generated by the conference.