Antiretroviral therapy in previously untreated adults infected with the human immunodeficiency virus type I: established and potential determinants of virological outcome

The aim of highly active antiretroviral therapy (HAART) for patients chronically infected with the human immunodeficiency virus type I is to achieve maximal and durable viral suppression. Maintaining the blood plasma HIV-I-RNA concentration (pVL) <50 copies/ml is currently considered appropriate for this goal. With the current treatment options, the percentage of previously untreated patients who achieve a pVL <50 copies/ml after one year of initial HAART is about 70%. Characteristics of the host, virus, drugs and the treatment team have been associated with the virological response to initial HAART. Adjusting the initial HAART regimen and patient management to a risk profile based on these factors is possibly helpful in improving the virological response to HAART. Adherence to a potent and well-tolerated HAART regimen is likely to be the most relevant factor for virological success. The additive value of the other factors needs to be clarified