As this review is written, a mood of pessimism envelops scientists involved with human immunodeficiency virus (HIV) infection. A couple of years ago, the Concorde study—highlighting the severe limitations of antiretroviral therapy—struck hard at those wishing for a "magic bullet," a drug that would halt the catastrophic effects of the immune system-destroying virus that was discovered only a decade before but which had already killed hundreds of thousands of people around the world. Paralleling this pessimism, advances in clinical management of HIV disease moved into low gear. Perhaps it was inevitable. The rapid accumulation of knowledge couldn't continue at such a pace forever.
Reflect for a moment on some of what we have learned in the past few years: proof that several drug regimens can successfully prevent most cases of Pneumocystis carinii pneumonia, use of oral ganciclovir to prevent cytomegalovirus retinitis and its resulting blindness, discovery of a host of