HIV–25 years later: It's not a death sentence anymore, but drug resistance is a rising concern as research continues on a preventive vaccine

Twenty-five years after the first published report of Pneumocystis carinii pneumonia in five previously healthy young men in Los Angeles, an event that later would identify the first cases of acquired immunodeficiency syndrome, the AIDS epidemic is still with us. Although great strides have been made over the past quarter century, including improving mortality rates among patients with the introduction of lifesaving medications, cleaning up our blood supply, and increasing public awareness, there are still challenges to be faced.

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Impressive results were seen in the 24-week pooled data from the POWER 1 and 2 trials that led to darunavir's approval. In treatment-experienced patients, twice-daily darunavir/ritonavir plus an optimized background regimen (OBR) was compared with another PI-containing regimen. Results showed that patients in the darunavir group were significantly more likely to achieve a virologic response (69.5% vs. 21%), defined as a 1.0 log10 reduction in the viral load. Furthermore, 45% of darunavir users achieved an undetectable viral load (less than 50 copies/ml) versus 12.1% in the other group.