Clumeck N
Service des Maladies Infectieuses, C.H.U. Saint-Pierre, U.L.B.
Rev Med Brux. 1999 Sep;20(4):A373-6.
In recent times important progress has been made in the treatment of HIV. Plasma viral load count is now used in routine practice permitting a accurate evaluation of each patient and in particular the risk of progression to symptomatic AIDS. A better understanding of the natural history of HIV has enabled physicians to recognise the need for commencing treatment early. The availability of more effective therapies like protease inhibitors and their use in tritherapy regimens permit more ambitious therapeutic strategies aimed at prolonging life and perhaps even viral eradication. Already the first positive effects of these treatments have been observed with the reduction of mortality and in hospitalisation rates, etc. The impact of these developments on the prevention and testing for HIV is of course very important with the risk of a demobilizing effect in primary as much as in secondary HIV prevention. Conversely the possibility of very early treatment is a major argument for effective education on early HIV testing. The future politics of prevention and testing must be elaborated taking into account these changes in the public perception of HIV.