An ongoing dialogue on HIV/AIDS, infectious diseases,
July 1st, 2012
“HAART Era” Now Longer Than “Pre-HAART Era” — Can We Officially Retire “HAART”?
As I’ve shared before, I’m no fan of the term “HAART” and do everything I can to stop people from using it.
(I’m a fun guy to have at parties.)
I’m returning to this pet peeve of mine because I realized recently that we’ve passed a milestone of sorts:
- Period of no effective HIV treatment, 15 years (1981-1996)
- Period of effective HIV treatment, 16 years (1996-2012)
I came to this realization while reviewing a manuscript on an HIV-related complication. The author repeatedly (and at great length) described how this complication had changed with the “advent of HAART” (cringe) –incidence down, prognosis better, management altered. There were many comparisons between the “pre-HAART era” and the “post-HAART era”, even a separate table on the differences.
Of historical interest, yes, but hardly earth-shattering news at this point , and not of much practical use to the reader –pretty much everything changed with effective HIV treatment.
The bottom line is that HIV-related complications should be considered now only in the context of patients who are receiving, or who are about to receive, antiretroviral therapy. In other words, describing how to manage HIV-related complications without HIV treatment would be like an endocrinologist describing management of Type 1 diabetes complications without insulin.
So since HIV treatment is now the new normal — becoming more so with each passing year — let’s just call it antiretroviral therapy, and assume that it’s standard of care to give the highly active kind.
And if you want to abbreviate it, “ART” will do just fine.
6 Responses to ““HAART Era” Now Longer Than “Pre-HAART Era” — Can We Officially Retire “HAART”?”
Paul E. Sax, MD
Associate Editor
NEJM Clinician
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I think the abbreviation ‘cART’ works very well, too.
Dr. Sax,
I have been using the abbreviated version, “ART” for several years now when speaking with fellow HIV patients and my own physicians. Mainly because I have never heard of a low-active antiretroviral therapy (LAART or LOL)! Thanks for providing a rationale for this.
Peace,
Ken
Sir, Starting early HAART, HAART for people above CD4 count 500, HAART for all antenatal mothers when their CD4 is above 500, treatment for ccute infection, PrEP—- Are we going in right direction? Or are we making their system including bone marrow,liver, kidney, nervous system, alimentary system, bones, metabolism of the body get spoiled earlier. It is the time to reconsider. I think everything went alright even before when the HAART started after CD4 less than 350. We are making the people to suffer with problems other than AIDS. We are also spoiling very good drugs earlier with the development of mutations. Are we not?
HAART has been used to differentiate more efficacious triple or quadruple drug therapy from monotherapy, which was used in the early treatment days.
Since multi-drug therapy has been the standard of care for well over a decade and monotherapy is no longer used, “HAART” is a passe term. I too believe it can reasonably be retired.
I’ll never say or write HAART again and ask that newspaper writers immediately retire the melodramatic “full-blown AIDS” and the “cocktail” too.
Excellent words of wisdom, Dr. Sax. Time to retire the “HAART” usage.. Any news on the revision of PEP guidelines?? Was topic of previous blog, but haven’t heard any more about it..