HIV medicine

HIV/AIDS is a dynamic and fast-moving specialty. In the early stages of the HIV pandemic, mortality was high, and treatment was limited to management and prevention of opportunistic infections. More recently, treatment improvements have meant that HIV has been transformed from a fatal condition to a chronic infection, with dramatic improvements in life expectancy. Combined data from clinical trials now show life expectancy similar to the general population among those stable on antiretroviral therapy. Although the prognosis of people living with HIV has improved, 34 million people are estimated to be living with HIV globally, and issues of access to, and retention in, care persist in resource-constrained settings. In the UK, with good access to, and retention in, care, late diagnosis is the main threat to successful treatment outcomes. This chapter presents the evidence that guides current practice in HIV medicine. This evidence largely refers to treatment of HIV-1 infection.