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Starting Highly Active Antiretroviral Therapy for HIV Infection: Is It WIHS To Wait?

Robert T. Schooley, MD
[+] Article, Author, and Disclosure Information

From University of Colorado Health Sciences Center; Denver, CO 80262.

Potential Conflicts of Interest:Consultancies and Honoraria: Bristol Myers-Squibb, GlaxoSmithKline, Merck, Pfizer, Roche, Vertex, ViroLogic, Tanox, Gilead; Stock ownership or options (other than mutual funds): ViroLogic, Tanox, Vertex; Grants received: Merck, Tanox; Grants pending: Pfizer, Tibotec.

Requests for Single Reprints: Robert T. Schooley, MD, Division of Infectious Diseases, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, B-168, Denver, CO 80262; e-mail, Robert.Schooley@UCHSC.edu.

Ann Intern Med. 2004;140(4):305-306. doi:10.7326/0003-4819-140-4-200402170-00014
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Since the advent of combination antiretroviral chemotherapy in 1995, we have witnessed one of the most remarkable reversals of fortune in any disease in the history of medicine. In 1984, the median survival for HIV-1–infected persons with Pneumocystis carinii pneumonia was about 6 months; it is now closer to 10 years and might be longer. Nonetheless, it is clear that therapy causes toxicity in some patients and leads to economic costs in all patients. These issues have appropriately triggered discussions about how to individualize therapy to maximize benefit, minimize toxicity, and reduce financial costs to society.

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