Current Management Challenges in HIV: Tolerability of Antiretrovirals and Metabolic Complications

The use of antiretroviral therapy for HIV infection has led to substantial reductions in morbidity and mortality. Many regimens, such as those combining three or more antiretroviral agents, result in near-complete suppression of HIV replication. Increased attention to short- and long-term toxicities of antiretroviral therapy reflects a number of factors including the indefinite duration of antiretroviral therapy required to preserve clinical benefit, the variety of antiretrovirals available, the use of antiretrovirals in combinations, and the declining incidence of HIV-associated opportunistic disease. Long-term success requires therapy to be individualized, carefully balancing toxicities with efficacy and resistance.