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"Since the introduction of highly active antiretroviral therapy (HAART) in the late 1990s, management of patients with human immunodeficiency virus (HIV) infection has improved where they are living longer and with fewer incidences of opportunistic illnesses. Furthermore, significant progress has been made in the understanding of the disease, the ability to quantify viral load and correlate with clinical outcomes, genotypic and phenotypic resistance assays designed to assess viral susceptibility, and a heightened awareness and appreciation of the importance of treatment adherence to ensure virologic suppression.' In spite of the benefits that HIV-infected patients may have acquired in terms of more antiretroviral agents to select from and with more antiviral potency, the newer HAART regimens should not be overlooked as simple and tolerable medications. In fact, HAART regimens are ever more complex and challenging because of the high pill burden, drug-drug or drug-food interactions, formulation characteristics, and long-term drug class-associated side effects. While the goal of HIV therapy is to achieve maximal viral load suppression to undetectable levels ( <50 copies/ml) and to improve and stabilize the immune system (CD4 cell count >250 cells/mm3), successful pharmacologic management has become difficult due to a continued high rate of treatment non-adherence. Consequently, viral resistance to several HAART regimens inevitably develops, which ultimately leads to drug failure."


This article was originally published in California Pharmacist Journal, volume 53, issue 1, in 2006.


California Pharmacists Association



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