The great number of antiretrovirals available to set up a potent end durable therapy poses many questions in terms of decision. We are not referring to solutions as defined by guidelines, that usually define a sort of “standard way to deal with”. We are more interested to explore strategies of innovation that could arise from different approaches that take into account which drugs we could use in a different way, taking into account the main issues we are facing in these hard days. On one side we have financial constraint –it’s true-, but on the other side we are sitting on a great success: HIV/AIDS is now a chronic condition; the therapeutic armamentarium is crowded and neither potency neither efficacy are still on discussion. On stage, there are key issues like compartmentalization, simplification, future options and –mainly- safety.
In order to address these issues we met four experts in order to speculate –on the ground on the present data- which could be the spaces for different, may be future, options in terms of strategies dealing with HIV as chronic infection and HAART as chronic therapy.
We chose the experts from different fields (and persona attitude) in order to draw the picture as complete as possible: David Back because he is the leading expert in terms of HIV/AIDS pharmacology applied to clinical decision; José Gatell, because he is a clinicians who worked in HIV/AIDS since the beginning; Mark Weinberg because he is a basic science researcher working on translational approach, also adopting radical positions: he was one of the first to claim for microbiocides and now –once again- he is supporting a non-traditional use of antiretrovirals like PREP (as you can read in the box, pag x); Mark Nelson, a real provocative clinician who seek to define innovative way to deal with ARV, lying in the tradition –as only an English man can do.
The following pages aim to be an open door to the possible and to the future: a door that could be used by anyone of our readers, who wants to say something and adding his/her opinion about these topics.
Closing this issue of HAART FDA decided to approve the first drug to prevent HIV infection.
We had already decided to put a box on this “non conventional use of ARV”. We will be back on this topic for many reasons, not only medical but also sociological and cultural.
Everyone who would send us his/her comment on PREP and FDA approval to join the forum will be welcome.
Articolo presente in – HAART and correlated pathologies n. 15 –