Monitoring anti-HIV therapy

1. Viral Load
Initiation - viral load is now the preferred method of monitoring therapy. There should be >= 1 log reduction in viral load, preferably to less than 10,000 copies/ml HIV-RNA within 2-4 weeks after the commencement of treatment. If <0.5 log reduction in viral, or HIV-RNA stays above 100,000, then the treatment should be adjusted by either adding or switching drugs.
Monitoring - viral load measurement should be repeated every 4-6 months if patient is clinically stable. If viral load returns to 0.3-0.5 log of pre-treatment levels, then the therapy is no longer working and should be changed.
2. CD4 count
Initiation - within 2-4 weeks of starting treatment, CD4 count should be increased by at least 30 cells/mm3. If this is not achieved, then the therapy should be changed..
Monitoring - CD4 counts should be obtained every 3-6 months during periods of clinical stability, and more frequently should symptomatic disease occurs. If CD4 count drops to baseline (or below 50% of increase from pre-treatment), then the therapy should be changed

As a result of HAART, mortality from HIV has declined continuously in the N. America and Europe. However, the long term outlook remains uncertain. These drugs are very expensive and the patient needs to take them for life. Therefore, there is a question of compliance. It had been suggested that it would take at least 7 to 10 years to eliminate all HIV particles in an infected person.

Diagnostic Tests	Prognostic Tests	Antiviral Susceptibility Tests	Treatment
3 Types of Inhibitor	Monitoring anti-HIV therapy	Prevention