Advances in antiretroviral therapy.

The 14th Conference on Retroviruses and Opportunistic Infections provided a forum for presentation of state-of-the-art research on antiretroviral therapy. This year's conference marked the first public presentation of phase III trials of the lead compounds in 2 new drug classes: maraviroc (a CCR5 inhibitor) and raltegravir (an HIV-1 integrase inhibitor). These agents are likely to be approved by the US Food and Drug Administration this year and should provide major new options for treatment-experienced patients with multidrug resistant virus. Other dominant themes of the conference were the impressive number of presentations describing outcomes of antiretroviral therapy programs in resource-limited settings and new information on mechanisms of drug resistance. Among the latter, the importance of drug resistance mutations occurring in the RNase H and connection domains of the HIV-1 reverse transcriptase was of special note. In addition, substantial new information was presented on other new antiretroviral agents, studies in treatment-naive patients, antiretroviral therapy strategies, prevention of mother-to-child transmission, predictors of clinical response to therapy, and antiretroviral pharmacokinetics. Research in antiretroviral therapy remains dynamic and advances in the field continue to improve our ability to maintain long-term control of HIV-1 replication in infected persons.