The primary goals of antiretroviral therapy are maximal and durable suppression of plasma viral load, preservation and/or restoration of immunologic function, improvement of quality of life and reduction of HIV related morbidity and mortality.

• Clinical benefit has been demonstrated in controlled trials only for patients with CD4+T cells <200/mm3. However, most experts would offer therapy at a CD4+T cell threshold <350/mm. All decisions to initiate therapy should be based on prognosis for disease-free survival in the absence of treatment, as determined by the CD4+ cell count and level of plasma HIV RNA shown in Table 5, the potential benefits and risks of therapy shown in Table 4, and the willingness of the patient to accept therapy.

Goals of HIV Therapy and Tools to achieve them Goals of therapy

• Maximal and durable suppression of Viral load.
• Restoration and/or preservation of immunologic function.
• Improvement of quality of life.
• Reduction of HIV related morbidity and mortality.

Tools to Achieve Goals of Therapy

• Maximum adherence to the antiretroviral regimen
• Rational sequencing of drugs
• Preserving future treatment options.
• Use of resistance testing in selected Clinical settings where possible.