The Body Covers: The XIII International AIDS Conference
Animal Models -- Interventions
July 10, 2000
Dr. Vaslin's presentation (MoOrA102) showed similar effects. Twelve cynomolgus macaques received AZT/3TC/IDV immediately after an intravenous infection, and then experienced lower viral loads and less CD4 declines after therapy was stopped.
I think these papers have profound implications in our approach of acute seroconversion. Current guidelines suggest the use of combination therapy, without a clear determination of the length of time, but with the implicit assumption is that is going to be for life. Perhaps these guidelines are wrong. Perhaps the right thing to do is to treat patients with acute seroconversion for a certain period of time and then stop therapy, let the immune system set a "set-point" lower than what it would have been without the intervention and restart the treatment when clinically indicated. If this is the case, networks would have to be established to identify patients with acute seroconversion and therapy would have to be administered for a short period of time, which obviously would be much cheaper than treatment for life. Obviously, this approach could even be used in the developing world.
This idea will obviously have to be tested in the setting of a clinical trial, comparing this approach to placebo, or continuous therapy as the current guidelines suggest.
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