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Viral Dynamics of HIV: Implications for Drug Development and Therapeutic Strategies
- Diane V. Havlir, MD; and
- Douglas D. Richman, MD
- From the University of California, San Diego, and the San Diego Veterans Affairs Medical Center, San Diego, California. Acknowledgments: The authors thank Jacqueline Martinez and Darica Smith for manuscript preparation. Grant Support: By grants AI 27670, AI 36214, AI 29164, and AI 30457 from the National Institutes of Health; by the Research Center for AIDS and HIV Infection of the San Diego Veterans Affairs Medical Center; and by the California Universitywide Taskforce on AIDS. Requests for Reprints: Diane V. Havlir, MD, University of California, San Diego Treatment Center, 2760 Fifth Avenue, Suite 300, San Diego, CA 92103. Current Author Addresses: Dr. Havlir: University of California, San Diego Treatment Center, 2760 Fifth Avenue, Suite 300, San Diego, CA 92103.
Abstract
The ability to quantitate human immunodeficiency virus (HIV) in blood and tissues from patients at all stages of disease has provided new insights into the pathogenesis of HIV disease. There is a dynamic equilibrium between HIV production and clearance even during the period of clinical latency, which may permit resistant virus to emerge with the imposition of drug pressure. Disruption of the equilibrium with effective drugs reduces circulating levels of HIV within 1 week, thus allowing the rapid assessment of new candidate drugs. To maximize the magnitude and durability of HIV RNA suppression, therapeutic strategies must be implemented that are effective against high levels of rapidly replicating virus that consist of many genetic variants.
- Copyright ©2004 by the American College of Physicians
