%0 Journal Article
%T Recent key advances in human immunodeficiency virus medicine and implications for China
%A Kai Sun
%A Shuntai Zhou
%A Ray Y Chen
%A Myron S Cohen
%A Fujie Zhang
%J AIDS Research and Therapy
%D 2010
%I BioMed Central
%R 10.1186/1742-6405-7-12
%X Antiretroviral therapy (ART) has evolved from monotherapy with zidovudine (AZT) to the use of combination nucleoside reverse transcriptase inhibitors (NRTIs), to triple therapy with highly active antiretroviral therapy (HAART), to today's numerous combinations drawn from 6 classes and 32 drugs, including fixed dose formulations, approved by the United States (US) Food and Drug Administration (FDA) [1]. Treatment goals have also progressed from achieving viral suppression to regimen simplification, to long term durability, and to the present paradigm of treatment as prevention. In the past 2 decades, HIV mortality has dramatically decreased reflecting the success of ART [2,3]. New drugs with fewer side effects and lower pill burden have made long term viral suppression a reality. As death rates related to acquired immunodeficiency syndrome (AIDS) continue to decline in patients receiving treatment, attention has shifted to what have heretofore been considered non-AIDS-related deaths. In this paper we will review some of the most important recent advances in HIV medicine and comment on their significance for the future of HIV treatment and care in China.The US Department of Health and Human Services (DHHS) [4] and the World Health Organization (WHO) [5] both released new guidelines in 2009. The overall treatment strategies include earlier initiation of ART, individualized treatment based on comorbidities, and regimen optimization to minimize toxicity and potential for drug resistance.The new US DHHS guidelines for ART initiation have expanded to include all patients with pregnancy, HIV-associated nephropathy, and hepatitis B virus (HBV) coinfection requiring treatment for HBV, regardless of CD4 count, and in all patients with CD4 <350 cells/mm3. In addition, ART is now recommended for all patients with CD4 between 350 and 500 cells/mm3. As for patients with CD4 > 500 cells/mm3, the panel of experts is evenly split between favoring ART initiation and considering it opt
%U http://www.aidsrestherapy.com/content/7/1/12