This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The purpose of this study is to compare the long-term clinical consequences of two strategies of antiretroviral (AR) management for the Human Immunodeficiency Virus (HIV): (1) the drug conservation (DC) strategy, a strategy aimed at conserving drugs through episodic use of antiretroviral treatment for the minimum time to maintain CD4+cell count x 250 cells/mm^3 -versus- (2) the viral suppression (VS) strategy, a strategy aimed at suppressing viral load as much as possible, immediately following randomization and throughout follow-up, irrespective of CD4+cell count. The primary objective is to compare the DC group with the VS group for the following: -Survival -Incidence of major cardiovascular and metabolic complications -Incidence of serious disease progression events -Combined endpoint of clinical disease progression, major cardiovascular and metabolic complications, or death -Grade 4 adverse events -Self-reported changes in body appearance -Prevalence at selected time points of multi-drug resistant (MDR) HIV, and rate of developing MDR HIV -Adherence to antiretroviral treatment, averaged over follow-up -Disease progression, death, and other outcomes
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