The treatment of patients with HIV.
BACKGROUND
Infection with the human immunodeficiency virus (HIV) remains a major medical challenge.


METHODS
Selective literature review, including the current German/Austrian, European, and American guidelines on the treatment of HIV infection in adults.


RESULTS
In Germany, 3000 persons become infected with HIV each year; in 2009, 67,000 persons in Germany were living with HIV. When highly active antiretroviral therapy (HAART) is initiated in time, patients can achieve a nearly normal life expectancy. Nonetheless, in Germany as elsewhere, 30% of patients receive the diagnosis of HIV infection only when they have reached the AIDS stage of the disease or are suffering from advanced immunodeficiency. HAART should be started, at the latest, when the CD4-positive helper cell count drops below 350/microL. Primary drug resistances, accompanying illnesses, and the patient's living circumstances must all be taken into account in the selection of antiretroviral drugs. The goal of treatment is lasting suppression of HIV-RNA to below 50 copies per milliliter of plasma.


CONCLUSIONS
HIV testing should be offered to all patients at high risk for HIV infection and all persons newly diagnosed with a sexually transmitted disease. As persons with HIV grow older, their treatment is complicated by increasing comorbidity and requires increased vigilance for possible drug interactions.
Vogel
Martin
M
Medizinische Klinik und Poliklinik I, Universitätsklinikum Bonn.
Schwarze-Zander
Carolynne
C
Wasmuth
Jan-Christian
JC
Spengler
Ulrich
U
Sauerbruch
Tilman
T
Rockstroh
Jürgen Kurt
JK
D015492:AIDS Serodiagnosis; D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D005858:Germany; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D055815:Young Adult
D012367:RNA, Viral