Structured Treatment Interruptions: In Brief

Recently there has been a great deal of interest in Structured Treatment Interruptions (STIs) among researchers and people living with HIV.

One potential goal of STI is to improve a person's immune response against HIV so it can help control viral replication with less aggressive treatment or no treatment at all. Another potential goal of STI is to replace drug-resistant virus with non-resistant (wild-type) virus, thus restoring a person's sensitivity to drugs that had previously become ineffective due to resistance. Also, STIs might give people who are experiencing treatment fatigue or severe side effects a break from therapy long enough to allow some degree of healing, both physically and psychologically.

A slight variation on STI, called Structured Intermittent Therapy (SIT), is also being researched. SIT seeks to determine if it's possible to control HIV by using anti-HIV drugs at regular intervals rather than every day, while still maintaining control of viral load. If this could be done without harm, it could greatly lower the cost of treatment and perhaps reduce the risk of some side effects.

Early results have recently been reported from a few small SIT studies and a couple of larger STI studies. These results have been quite mixed although some are encouraging. Early results from one study suggests that the majority of people in a cycle of seven days on anti-HIV therapy and seven days off were able to keep their HIV levels under the limit of detection with currently available viral load tests. Several other studies are ongoing to determine how STIs and SITs could fit into a long-term treatment strategy.

Project Inform will co-sponsor a second STI workshop in October 2000 to identify potential gaps in the research and to brainstorm on how the studies may be enhanced. The Forum for Collaborative HIV Research (FCHR), the Foundation for AIDS and Immune Research (FAIR) and the Treatment Action Group (TAG) will also co-sponsor this event. So stay tuned!

For more information on STIs and SITs, call Project Inform's National HIV/AIDS Treatment Hotline and ask for the publications, PI Perspective #31 or Structured Treatment Interruptions.

Back to the Project Inform WISE Words October 2000 contents page.