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Treatment interruption shows no benefit in drug-resistant HIV infection

Prescribed interruptions in antiretroviral therapy--so-called "drug holidays"--may hasten disease progression in a subset of HIV-infected individuals, namely those whose treatment has been rendered significantly less effective by the development of resistance to multiple anti-HIV drugs (MDR-HIV). This was the finding in a study by researchers supported by the National Institute of Allergy and Infectious Diseases (NIAID), one of the National Institutes of Health (NIH).

As reported in the August 28, 2003 issue of The New England Journal of Medicine, researchers found that study participants who underwent a four-month structured treatment interruption had more HIV-related complications and poorer immune response than did individuals who took antiretroviral drugs continuously throughout the study.

"Interruption of treatment has become increasingly common among HIV-infected individuals," says NIAID Director Anthony S. Fauci, M.D. "This study helps to clarify the effects of treatment interruption in one group of patients and emphasizes how important it is for people to join clinical trials to help answer questions that will improve patient care."

As used in this study, structured treatment interruption involves discontinuing all anti-HIV drugs for a defined period of time to allow the repopulating virus to regain susceptibility to anti-HIV drugs. Previous studies of individuals infected with MDR-HIV have shown that drug-sensitive variants of the virus re-emerge and become predominant after therapy is stopped. Treatment interruptions have also been used to give people time off from multiple medications that may be difficult to take and have toxic side effects.

"We had hoped that a structured treatment interruption would be beneficial for people experiencing treatment failure due to multidrug-resistant HIV," says study chair Jody Lawrence, M.D., of the Department of Medicine at the University of California, San Francisco. "However, our resul
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Contact: John Bowersox
jbowersox@niaid.nih.gov
301-402-1663
NIH/National Institute of Allergy and Infectious Diseases
27-Aug-2003


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