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HIV/AIDS Early Treatment Controversy Cues New Advice but Questions Remain

Marsha F. Goldsmith
JAMA. 1993;270(3):295-296. doi:10.1001/jama.1993.03510030015003.
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IN THE ATMOSPHERE of confusion about how best to treat people infected with the human immunodeficiency virus (HIV) that was engendered by reports at the Ninth International Conference on AIDS, held last month in Berlin, Germany, a panel convened by a US government agency met 2 weeks later in Bethesda, Md, to consider all the evidence and suggest a new, state-of-the-art, therapeutic approach.

At what point physicians should reach into their scant antiretroviral armamentarium for one of the three drugs approved to intervene in the natural history of infection with the virus was the issue addressed by a group of nongovernmental experts on the acquired immunodeficiency syndrome (AIDS).

The panel's 18 members convened for 3 days at the National Institute of Allergy and Infectious Diseases and issued somewhat cautious and necessarily complicated new recommendations— the first since 1990—for treating persons with the disease. While there is no regulatory authority behind


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