Antiretroviral therapy for HIV infection: a review of current medications and therapies.

Background: Management of HIV infection has been revolutionized in the past 3 years by the introduction of drugs significantly more potent than those previously available. Simultaneously revelations about dynamics of HIV infection and viral replication have altered concepts about HIV disease, as well as the need for therapeutic interventions.

Methods: A literature search was conducted of journals listed in the Index Medicus, as well as abstracts from annual meetings of the American Society for Microbiology, the Infectious Disease Society of America (Conference on Retroviruses and Opportunistic Infections), and the International Conferences on AIDS.

Results: Antiretroviral drugs of four differing pharmacologic classes are able to achieve profound suppression of viral replication when combined in varying regimens. Costs of medications remain high, many toxicities are associated with drug therapy, and regimens are both complex and daunting. In spite of many difficulties associated with highly active anti-retroviral therapy (HAART), many patients are able to achieve improved quality of life and longer survival.

Conclusions: Optometrists, as members of the health care team, play a role in diagnosis and management of HIV patients, in providing encouragement and empathy to patients--particularly emphasizing the need for adherence to complex therapy regimens, as well as the importance of regular followup.