This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Walmsley, S. Articles by Loutfy, M. Search for Related Content PubMed PubMed Citation Articles by Walmsley, S. Articles by Loutfy, M. Pubmed/NCBI databases Medline Plus Health Information AIDS Medicines Social Bookmarking                         What's this?

Can Structured Treatment Interruptions (STIs) Be Used as a Strategy to Decrease Total Drug Requirements and Toxicity in HIV Infection?

University of Toronto, and Assistant Director, Immunodeficiency Clinic, Toronto Hospital, Toronto, Ontario, Canada

Mona Loutfy, MD, FRCPC

University Health Network, University of Toronto, Toronto, Ontario, Canada

Structured treatment interruptions (STIs) are a new strategy under investigation in clinical trials involving a number of different HIV-infected populations. These populations include patients with prolonged HIV RNA suppression who were treated in either seroconversion or later in disease, and patients with virologic failure despite HAART, prior to the initiation of a salvage regimen. The goals of STI vary in each of these groups. Until the results of clinical trials are available, the use of STIs must be considered experimental. There are a number of potential risks, including the loss of a significant number of CD4 cells with the development of opportunistic infections, rebound of HIV RNA, emergence of drug resistance, and reseeding of viral reservoirs. However, STIs also hold the promise for decreasing antiretroviral drug burden and toxicity, and improving quality of life. Given that much of the world’s population infected with HIV does not have access to continuous HAART, the development of strategies that could decrease overall drug burden and cost is important.

This paper provides an update of the recently published and presented studies on the use of STIs in various populations of HIV-infected patients. In particular, it discusses what is known and unknown about the relative risks and benefits of this approach, and what studies are ongoing. Lastly, it identifies how the use of STIs could decrease drug burden and toxicity in patients receiving therapy.

Key Words: structured treatment interruption • antiretroviral therapy • drug toxicity • HIV • HAART

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 1, No. 3, 95-103 (2002)
DOI: 10.1177/154510970200100304


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?