Drug Halt Can Reduce Resistance in Late-Stage AIDS

Advanced AIDS patients who have become resistant to treatment with all available HIV drugs might benefit from strictly controlled treatment interruptions, Dr. Christine Katlama of Hospital Pitie-Salpetriere in Paris said on Wednesday at the 14th International AIDS Conference. Katlama said taking these patients off their medications for a period of eight weeks in a well-monitored hospital setting made the virus in their bloodstream susceptible to drug treatment once again.

Structured treatment interruptions are a subject of debate among AIDS researchers. With results of several studies mixed, however, most researchers think the approach cannot currently be recommended except under closely monitored conditions.

The French team studied a group of 68 patients who had exhausted all currently available HIV drug therapies. Eligible patients had to have more than 50,000 copies of the virus per milliliter of blood and CD4 counts below 200 cells per microliter. Half the study group were immediately given a "salvage" therapy including as many as nine antiretroviral drugs, while the other half were given an eight-week break before starting the rescue treatment.

More than half of the patients in the deferred treatment group became responsive to at least one class of drugs they had previously been resistant to, Katlama reported. Interrupting the treatment seemed to have no adverse effects, she added, but the patients were already very sick.

The amount of virus in the blood of patients who did not have treatment interruption remained constant for 24 weeks after the study began. In contrast, viral levels in those who had a break in treatment dropped by a factor of ten after 24 weeks of resumed drug therapy.

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