• Treatment for AIDS-defining illness: A new treatment for oral thrush is at least as good as existing ones and may reduce the rate of relapse; and British doctors report the best ever survival rates of people with a rare brain disorder called PML, when treated with a combination of anti-HIV drugs including a protease inhibitor and an antiviral drug called cidofovir.

• HIV treatment: Tests to monitor levels of anti-HIV drugs in the blood may be of little value as levels can vary substantially within individuals; the protease inhibitor atazanavir/ritonavir may interact with a heroin substitute; and a rare HIV drug resistance mutation means that multiple drugs from the nucleoside/nucleotide class of antiretrovirals don’t work.

Treatment of AIDS-defining illnesses

Potent anti-HIV therapy can mean a much longer and healthier life for people with HIV; indeed some doctors are now so optimistic about the long-term effectiveness of HIV treatment that they are confident that a person who is doing well on antiretrovirals will live a normal lifespan.

Although there has been a significant decline in the number of AIDS-defining illnesses since effective anti-HIV treatment became available in the mid-1990s, approximately 400 individuals are diagnosed with AIDS a year in the UK and a similar number of deaths are attributed to HIV. Much of this illness and death occurs in people who only found out that they had HIV when they had a very weak immune system and low CD4 cell count.

Anti-HIV treatment suppresses HIV viral load enabling the immune system to recover and fight infections, and much of HIV medicines is now focused on how best to use antiretroviral medicines. But doctors still need to know how to treat the infections which people with HIV and weakened immune systems are vulnerable to, and better treatments for these infections are needed.

Anti-HIV treatment