Induction and Maintenance Therapy for Opportunistic Infections in Patients with AIDS

Abstract

The acquired immunodeficiency syndrome (AIDS) has clearly illustrated the vital role of an effective cellular immune system in the successful chemotherapy of many infections. Most drugs used to treat fungal, protozoan, viral, and some bacterial infections are capable of inhibiting growth of the pathogen (static), but do not kill or destroy it. These static agents require an effective cellular immune (monocyte-macrophage) system to ensure that the infecting organism(s) is eradicated and relapse prevented. The cellular immune system is severely impaired in patients with advanced human immunodeficiency virus (HIV) infection (AIDS). Thus, a more aggressive approach to therapy of infections complicating HIV disease is emerging. This approach, which includes an initial induction phase followed by a chronic suppressive or maintenance phase, comprises a strategy that mimics the approach of the oncologist to chemotherapy of malignancies.