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non 7-on 7-off SIT
Mar 31, 2002

I do my SIT nine days on, five days off. What do you think about that? I tried 7 days on - 7 days off but got sick on two occasions and dropped back to this more conservative cycle. Perhaps unrelated but I took it as a sign and haven't had a problem since switching to 9/5.

Response from Dr. Cohen

Interesting comment, and this is certainly an important observation.

We researchers have been exploring what to do with the challenges and imperfections of maintaining control of HIV, while minimizing their toxicity. And treatment interruption is among the newer approaches. So far, there is the ten person study done at the NIH in the US that showed that those who stopped for 7 days, retreating for 7 more, and alternating this schedule, could maintain control of HIV. This ONLY applies to those whose viral load were already below 50 copies. But does teach us something about where research can go next.

Including other schedules. And this may include the variations such as what you describe. It however is not so clear why a longer period on meds, and a shorter time off meds, for you would do better than the 7/7. Nonetheless, it is likely that if 7 days off can work to maintain control of HIV once suppressed, then 5 days off should be even easier. And if 7 days back on is successful, than 9 on should be even more successful. So yes, it is more conservative. But for some reason you are doing even better. And I too have at least one person on this schedule - with ongoing success as well.

Research into interruptions is just beginning. We have much to learn. For example, the 7/7 schedule worked for ten people. Will it work for a hundred more? Or will HIV come back and create rebound and resistance for some? Will some people have even more side effects when restarting meds after stopping? Many questions and much work to be done. But it is clear that, as you note, there are reasons to do the research. Since, for some, these interruptions may be safe and helpful.

Hope that helps.



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