HIV therapy: taking advantage of progress

Published on August 30, 2018   34 min

A selection of talks on Immunology & Inflammation

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HIV therapy. Taking advantage of progress, and I'm Paul Valberding from the University of California, San Francisco.
The outline of my presentation is shown on this slide. I'll talk about the goals and benefits of therapy. When treatment should start. What is the recommend first-line treatment? Can side effects and drug resistance be avoided? What new approaches are in progress? The role of antiretroviral drugs in prevention? What is being done to cure HIV infection? And then finally, and a very brief summary of various approaches to HIV care systems.
The goals of HIV therapy are really quite simple. First, we want to suppress HIV replication to levels non-detectable by the most sensitive available assays. We want to continue lifelong treatment with no interruptions. We want to avoid all drug toxicity both short and long-term, and we want to treat all infected persons globally as soon as HIV is diagnosed.
If we do our best, what are the outcomes of successful HIV therapy? We will see the CD4 counts stay or rise to healthy levels. We will prevent opportunistic diseases, and we will prevent all further HIV transmission by all routes.
In our early days of therapy showed that we could slow the virus down, but our earliest treatments did not reverse the disease. This is a typical slide of an AZT trial in the early days of the epidemic where you see that compared to placebo, AZT slowed the time of decline in the CD4 cell count, but it didn't make the CD4 cell count increase.