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Issues Regarding Antiretroviral Treatment for Patients With HIV-1 Infection

Conrad Fischer, MD
JAMA. 1997;278(15):1234. doi:10.1001/jama.1997.03550150038027.
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To the Editor.  —I want to thank Dr Carpenter and colleagues1 for making a bold and accurate statement concerning the use of antiretroviral medications in perinatal transmission. Although the authors stop short of recommending the otherwise universal use of combination therapy in this group, as least they inform our colleagues that they do not have to stop or withhold treatment when necessary for the health of the mother. Although many may say that this is obvious, my experience as a provider of care for numerous HIV-positive pregnant women in New York City points otherwise. I continue to see clinicians stopping all but zidovudine therapy in pregnant women with low CD4+ cell counts and high viral loads on the basis that zidovudine is the only recommended therapy.Far too many individual authors and advisory panels have sidestepped this critical issue. Indeed, the US Public Health Service would be wise to revise its zidovudine-only


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