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The most effective treatment for HIV/AIDS is antiretroviral therapy, a regimen of several powerful drugs taken over a lifetime that can cause serious side effects, including liver damage. A clinical study reported [August 10] in the British journal The Lancet examines the risks and benefits of taking breaks in this anti-AIDS treatment.
The study divided patients into two groups. One received continuous treatment and the other did not. Therapy was interrupted according to the patients' CD4-count, a measure of the strength of their immune systems and an indicator of the progression of HIV, the virus that causes AIDS.
When the count dipped below 350, drugs were administered again. Lead author Bernard Hirschel heads the HIV/AIDS unit at the University Hospital in Geneva. He says the 2-year study found little difference between the two groups. "The group that had interrupted treatment had less side effects from treatment, but had some minor effects from the HIV virus. But the group that continued treatment had less effect from the virus, but more side effects."
Hirschel says scientists have long feared that if treatment were halted, the HIV infection would become resistant to drugs when therapy was restarted. "And we did not find that," he says. "The treatment remained effective. It was as effective when we started treatment again as it had been before treatment was interrupted. And, the second fear was that interrupting treatment might cause some acute disease, and this acute retroviral symptoms were not [present] or only very rarely observed."
Hirschel says the research gives hope to HIV/AIDS patients that therapy interruptions are safe. But it stops short of recommending that patients adopt the approach. He admits that a major U.S. study - based on different criteria - has found conflicting results and urges that more work be done to better advise caregivers and patients.