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SUMMARIZE THE BELOW INFORMATION USING YOUR OWN WORDS IN A PARAGRAPH> Five classes of antiretroviral medications, which target specific points of intervention in the multi-step HIV life cycle, have been developed for clinical use: (1) entry inhibitors, (2) NRTIs, (3) NNRTIs, (4) INSTIs, and (5) PIs. The Adult and Adolescent ARV Guidelines recommend the initiation of antiretroviral therapy for all persons with HIV to reduce disease progression and prevent transmission; this recommendation reflects evidence from clinical trials and cohort studies that have shown the benefits of starting antiretroviral therapy earlier in the course of HIV infection. In the Adult and Adolescent ARV Guidelines, the Recommended Initial Regimens for Most People with HIV consists of an INSTI anchor drug plus a 2-drug NRTI backbone. Other effective regimen options are available for use in certain clinical situations. The choice of the initial antiretroviral regimen depends on multiple patient factors, including medical and psychiatric comorbidities, patient preferences, and drug interactions. After the initiation of antiretroviral therapy, laboratory monitoring is important to measure the HIV RNA response to therapy, to follow the CD4 count, and to monitor for antiretroviral toxicity. Virologic response to antiretroviral therapy is the most important factor in predicting an overall successful treatment outcome, and most patients will achieve virologic suppression (HIV RNA below the lower level of detection of the assay, usually less than 20 to 75 copies/mL, depending on the assay used) within 24 weeks. Typically, individuals with HIV have a brisk increase in CD4 cells in the first 3 to 6 months after starting antiretroviral therapy, although a small proportion of patients fail to recover their CD4 count at a level greater than 200 cells/mm3 despite sustained virologic suppression. Scheduled antiretroviral treatment interruption is not recommended since this practice has been linked to an increased risk of opportunistic infection and death.

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