I. THE PATHOPHYSIOLOGY OF HIV THERAPY

The advent of potent antiretroviral therapy has altered the expected natural history of human immunodeficiency virus (HIV) infection and of many previously associated opportunistic compli-cations, including malignancies. At the same time, HIV suppression hasn’t affected all of these complications equally and the longer expected survival of infected patients may allow the devel-opment of newer complications. Additionally, the use of potent antiretroviral combination therapy may itself lead to hematological toxicities. To-gether these changes affect the consultation role of the hematology-oncology specialist in compre-hensive HIV care and demand ongoing education. In Section I, Dr. Paul Volberding reviews the biology of antiretroviral drug development and the progression in discovering new agents as the viral life cycle is further elucidated. He briefly summa-rizes the process of combining agents to achieve the degree of viral suppression required for long-term clinical benefit. In Section II, Dr. Kelty Baker reviews the effects of HIV and its therapy on hematologic dyscrasia and clotting disorders. She summarizes how therapy may decrease certain previously common manifestations of HIV disease while adding new problems likely to result in referral to the hematologist. In addition, she addresses the role of secondary infections, such as parvovirus, in this spectrum of disorders. In Section III, Dr. Alexandra Levine discusses the still challenging aspects of HIV associated non-Hodgkin’s lymphoma and the association between HIV infection and Hodgkin’s disease. She addresses current controversies in the pathogen-esis of HIV related lymphomas and summarizes a number of recent trials of combination chemo-therapy, with or without monoclonal antibodies, in their management. Additionally, she reviews the complex relationship of HIV disease with multicen-tric Castleman’s disease and recent attempts to manage this disorder