|How long are we from chronic meds?
Sep 4, 2006
Hi: To any doctor, realistically how far are we from chronic HAART, to some sort of therapy that will allow us to take intermittant breaks from HAART for viral control? Thanks.
| Response from Dr. Henry
The current paradigm for HIV treatment is chronic use of effective antiretroviral medications without interruption. For many patients who have little/no drug resistance and who now have suppressed virus and CD4 counts > 350-500 and who are not missing any doses--the goal is life long control of HIV (aiming for a normal life expectancy). Since current HIV drugs stop the growth of HIV but don't kill/eliminate resting or integrated HIV, certain forms of HIV persist for decades and can start growing again when treatment is stopped. Treatment interruption studies have generally been a failure (with generally unacceptable rates of clinical problems or resistance) except for those who have never had a low CD4 count (above 350) when treatment is stopped or started at relatively high CD4 cell levels (started when CD4 falls to 350), and results have been better when a boosted protease inhibitor has been used (to reduce resistance). For now treament interruption has to be viewed as a research approach not proven safe or effective for widespread use. KH
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