To treat or not to treat--approaches to antiretroviral therapy. Interview by Anthony J. Japour.

Academic Article


  • An interview with five experts on AIDS therapy, Dr. Robert Coombs, Dr. Scott Hammer, Dr. Michael Saag, Dr. Charles van der Horst, and Dr. Deborah Cotton, explores their impressions of the results from three large clinical trials. The trials--ACTG 175, Delta 1, and Delta 2--analyzed the efficacy of treatment with AZT alone compared to AZT combined with ddI or ddC, and ddI alone. Coombs states that the ACTG 175 results are the first convincing evidence of overall survival benefit with ddI compared with AZT alone. According to Hammer, the results suggest that AZT monotherapy may no longer be the optimal approach. Van der Horst said the results show that treatment outweighs no treatment, even at the beginning when CD4 counts are higher. Cotton observed that although the results show a benefit, she would not start therapy in an asymptomatic person. The experts also detailed what data they use to determine the best treatment to use for patients. Coombs said he uses the patient's CD4 cell count and clinical status, along with their viral load. Saag said his decision to treat asymptomatic patients is based on his understanding of how the virus causes disease and the pathogenesis of HIV infection.
  • Published In

  • Aids Clinical Care  Journal
  • Author List

  • Coombs R; Cotton D; Hammer S; Saag M; van der Horst C
  • Start Page

  • 1
  • End Page

  • 4
  • Volume

  • 8
  • Issue

  • 1