HIV Research: Directions After Durban

Highly active antiretroviral therapy (HAART) has been successful for many people, at least in the short-term, highlighting the immune system's amazing ability to restore itself. HAART's limitations are also clear, however, both in terms of long-term side effects and the seeming impossibility of making antiviral drugs accessible to the millions of people living with HIV worldwide. The 13 th International Conference on AIDS in Durban, South Africa cast a long-overdue spotlight on the disparities between the availability of HIV treatment for people in developing countries compared to those in North America and Western Europe. It also brings into sharper focus the urgent need to re-search and develop strategies that boost the immune system's ability to suppress HIV replication.

We've asked three regular CRIA Update contributors to discuss various aspects of immune reconstitution. Tim Horn provides an update on structured treatment interruptions, a follow-up to his report in our Spring 2000 issue. Anne Monroe looks at the recent data concerning when it's safe to stop medications to prevent opportunistic infections. Richard Jefferys offers a detailed overview of T-cell function, particularly as it relates to HIV, and explains why further research into the complex processes of the immune system is so important for the development of more successful and accessible HIV treatment strategies.

Our regular feature, "Drugs in Development," provides a look at the data on the most recently approved protease inhibitor and another in the pipeline. Finally, to start the issue off, our very own Dr. Jerome Ernst, CRIA's medical director, shares his insights after attending the Durban conference.