TOUGH DECISIONS MADE EASIER:
CLINICAL MANAGEMENT OF TREATMENT-EXPERIENCED PATIENTS

The 3rd Annual HIV CME symposium on this topic was sponsored by the UCLA CFAR and the Center for Clinical AIDS Research and Education (CARE) at the UCLA AIDS Institute.

This one-day symposium, which was underwritten in part by unrestricted educational grants from a dozen pharmaceutical companies, was designed to provide participants with relevant, reliable, up-to-the-minute information on the clinical management of HIV-infected patients who have failed one or more antiretroviral regimens, or who have demonstrated some degree of resistance to one or more antiretroviral agents or classes of agents. Drs. Ronald A. Mitsuyasu and Judith Currier, the directors of the CARE Center, were the chairs of the symposium.

“Our success in slowing the progression of HIV disease, coupled with our parallel success in preventing most of the opportunistic infections that we once saw in patients with well advanced disease, have bequeathed us an ever-growing population of extensively pretreated patients. Many of these patients are therapeutic veterans who have prevailed through monotherapy, dual therapy, the advent of protease inhibitors and the NNRTIs, and several temporarily effective multi-drug regimens. Some of them have survived serial hospitalizations; more have taken a planned or unplanned drug holiday; and all have accommodated themselves to the ever-present and not inconsequential side effects of chronic antiretroviral therapy."

”This patient population presents a unique challenge to the clinician. The management of these long-term survivors requires a high degree of individualization, constant vigilance, and a certain amount of educated guesswork. Here therapeutic guidelines of the sort promulgated by the U.S. Public Health Service and I.A.S.-U.S.A. are of limited help. Our purpose in convening this symposium is to help healthcare providers develop strategies for maintaining the clinical stability and the overall quality of life of this steadily expanding group of patients.”

Presentations were made by Mark Dybul, (”The U.S. Response to the Global AIDS Epidemic”), Eric Daar, (”New and Emerging Antiretroviral Therapeutics”). Roy Gulick, (”Clinical Use of HIV Entry Inhibitors”), Mark Wainberg, (”Clinical Relevance of HIV Drug Resistance Testing in Both Early Stage and Experienced Patients”), Marion Peters, (”New Insights Into Treatment of HCV and HBV in Patients on HAART”). and Judith Currier, (”Metabolic Complications of ART”).