Treatment optimization: an outline for future success

Flexner, Charlesa; Plumley, Benb; Brown Ripin, David H.c

doi: 10.1097/COH.0000000000000003
TREATMENT OPTIMISATION: Edited by David H. Brown Ripin, Charles W. Flexner and Ben Plumley

Purpose of review: In this issue of Current Opinion, the Guest Editors and their colleagues provide a comprehensive overview of current activities aimed at optimizing global HIV treatment. In this introduction, we outline current goals and approaches that will be described in more detail elsewhere in this issue.

Recent findings: Two recent conferences, the first and second Conference on Antiretroviral Drug Optimization (CADO), brought together experts from academia, governments, foundations, the pharmaceutical industry, and community activists to develop a global HIV-treatment research agenda for the coming decade focused on better therapies and how to make them accessible to a broader population of people living with HIV. Important recommendations included a focus on more efficient process chemistry for antiretroviral drugs, investigation of antiretroviral dose reduction as a possible optimization strategy, recognition of the increasing importance of concurrent infections and comorbidities especially tuberculosis and aging-related diseases, and identifying a highly effective and affordable nontoxic, once-daily fixed-dose combination regimen for first-line treatment.

Summary: HIV treatment optimization is a process intended to enhance the long-term efficacy, adherence, tolerability, safety, convenience, and affordability of combination ART. The ultimate goal of this process is to expand access to well tolerated and effective lifetime treatment to all those in need.

aJohns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland

bPangaea Global AIDS Foundation, Oakland, California

cClinton Health Access Initiative, Boston, Massachusetts, USA

Correspondence to Charles Flexner, M.D, Osler 527, 600 N, Wolfe Street, Baltimore, MD 21287-5554, USA. Tel: +1 410 955 9712; fax: +1 410 614 9978; e-mail:

© 2013 Lippincott Williams & Wilkins, Inc.