Duration of Therapy

It is known that residual HIV RNA and DNA in the lymph node will plateau after 1 year of highly active antiretroviral therapy in adults. At this time, these data suggest that there is not a good rationale for discontinuing therapy once it is begun. Non-protease inhibitor triple therapy combinations are available, and in this regard, antiretroviral efficacy and CD4 response with abacavir/lamivudine/zidovudine is equivalent to indinavir/ lamivudine/zidovudine after 24 weeks of therapy in antiretroviral-naive adults. Long-term effectiveness of antiretroviral regimens is strongly dependent on strict daily compliance. Alternative strategies to provide two-drug maintenance therapy after successfully reducing plasma HIV RNA levels to undetectable have been unsuccessful in sustaining a reduced viral load.4647

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