Introduction
The are probably few examples, if any, in the story of medicine like the one concerning the abrupt change that pharmacological research determined in the clinical evolution of HIV infection and AIDS.
In few months since the introduction of the first triple drug association deserving the acronym HAART (Highly Active Antiretroviral Therapy), the life expectancy of persons infected with HIV switched from a few years to a still indefinable time that we can today estimate as several decades [1]. Those physicians who are sufficiently aged to have assisted HIV-infected patients both before and after the introduction of HAART, have probably experienced one of the most important events in their life. It is often difficult in these times to make young doctors (and young patients as well) aware of the magnitude of the change that took place in the overall life perspective of humans infected with HIV. While for the newcomers to antiretroviral therapy it is rather natural to see patients’ immunity regain its competence under appropriate antiretroviral treatment, some of us still perceive something like a miracle in watching the reversal of such an otherwise deadly human disease. Most of our concerns today are related to side effects resulting from HAART rather than to its efficacy, and we are increasingly focusing on the long-term therapeutic balance (with issues like toxicity, tolerance and adherence) instead of lifethreatening opportunistic infections. A short paragraph on the natural history of HIV infection is thus fully justified in the intention to remind others of how things were, and still are in many geographical regions, before the use of multi-drug therapy transformed HIV infection from a lethal disease to a condition often compatible with a reasonably normal life.
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