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Confronting the Limits of Success

This feature article - timed to coincide with the AIDS 2002 meeting in Barcelona - documents the prevailing mood about the successes and limitations of antiretroviral drugs. Jon Cohen charts the development of different drug strategies since 1996 (when a cocktail of drugs was first shown to control HIV), and canvasses expert opinion on their successes and limitations.

The 16 anti-HIV drugs approved by the US Food and Drug Administration at the time are listed (the total is now 21). These have had enormous impact on AIDS-related disease and mortality in wealthy nations, changing HIV/AIDS from an imminently fatal to a chronic manageable disease. But the rise of drug resistance and long-term side effects are now increasingly apparent, although, as Cohen reports, developing nations have yet to have the advantage of experiencing these 'limits of success'.