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Adverse effects of medications and trade-offs between length of life and quality of life in human immunodeficiency virus infection

      In the mid-1990s, the availability of enhanced “combination therapy” antiviral regimens revolutionized treatment of patients with the human immunodeficiency virus (HIV) (
      • Hammer S.M.
      • Squires K.E.
      • Hughes M.D.
      • et al.
      A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less. AIDS Clinical Trials Group 320 Study Team.
      ,
      • Collier A.C.
      • Coombs R.W.
      • Schoenfeld D.A.
      • et al.
      Treatment of human immunodeficiency virus infection with saquinavir, zidovudine, and zalcitabine. AIDS Clinical Trials Group.
      ). Although efficacious in controlling viral expression in many patients, combination therapy does not cure the infection. Furthermore, in contrast with advanced infection, there is little published evidence that early initiation of combination therapy influences the course of HIV disease (
      ). In response, several recent articles have called for delays in initiation of therapy and an “individualized” approach to treatment (
      ,
      • Henry K.
      The case for more cautious, patient-focused antiretroviral therapy.
      ,
      • Harrington M.
      • Carpenter C.C.
      Hit HIV-1 hard, but only when necessary.
      ).

      Keywords

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