[Therapeutic attitude to HIV infection: uncertain and variable scientific attitudes. 1998 national survey of physicians prescribing antiretroviral drugs].
OBJECTIVE
Analyze the attitudes of French practitioners managing HIV infected patients towards multidrug antiretroviral therapies with protease inhibitors, open issues, and the official guidelines (Dormont report).


METHODS
A telephone survey was conducted in February-March 1998 on a random sample of the nation file of hospital physicians prescribing antiretroviral drugs (response rate 87%, n = 483).


RESULTS
The responding clinicians were in general agreement on defining virological efficacy at three months treatment as an undetectable viral load (86.5%). There was a general concensus on multidrug therapy with a protease inhibitor in case of primary infection (83.2%) or sexual exposure with risk of HIV transmission (83.2%). Inversely, only 43.7% abandoned PCP and toxoplasmosis prophylaxis in patients with CD4 counts above 350/mm3 taking tritherapy antiretroviral regimens. When asked to state their approach to a hypothetical case of an asymptomatic patient with a CD4 count of 450, 35.6% would not propose multidrug therapy with an antiprotease, 29.8% would only envisage such a regimen if the viral load was above 10,000 copies/ml, and finally 34.6% would prescribe a multidrug regimen with a protease inhibitor whatever the viral load.


CONCLUSIONS
The variability observed in routine clinical practices would appear to be justified in light of the uncertainty about the long-term effects of the new antiretroviral drugs for HIV/AIDS.
Landman
R
R
Service des Maladies Infectieuses et Tropicales, Hôpital Bichat-Claude Bernard, Paris.
Kertenian
I
I
Perrin
V
V
Huard
P
P
Moatti
J P
JP
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000821:virology; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D005260:Female; D005602:France; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D010820:Physicians; D011480:Protease Inhibitors / Q000627:therapeutic use; D012190:Retroviridae / Q000187:drug effects*; D011795:Surveys and Questionnaires
D000998:Antiviral Agents; D011480:Protease Inhibitors