Highly active antiretroviral therapy (HAART) for the treatment of infection with human immunodeficiency virus type 1

Highly active antiretroviral therapy (HAART) refers to a broad category of treatment regimens usually comprised of three or more antiretroviral drugs that, in previously untreated HIV-1-infected patients, are expected to redu ce plasma virus levels below the limits of detection. Most HAART regimens i nclude drugs from at least two of the three classes of antiretroviral thera py (nucleoside analog. reverse transcriptase (RT) inhibitors, non-nucleosid e analog RT inhibitors, and protease Inhibitors). In deciding when to initi ate antiretroviral therapy, physicians and their patients must balance the virological and immunological benefits of early treatment with the costs of drug therapy, the risk of drug side effects, and the risk of drug resistan ce if adherence is suboptimal. In previously untreated patients, HIV-1 repl ication can be suppressed indefinitely with certain HAART regimens. In prev iously treated patients, the benefits of HAART are often significantly dimi nished. (C) 1999 Elsevier, Paris.