Treatment Breaks: Safe for Some?

Although numerous studies during the past several years have shown that, in general, anti-HIV drug treatment breaks -- even when overseen by a primary care physician -- are dangerous and can lead to increased drug resistance or rapid disease progression, a new analysis has shown that such breaks might be viable for a select few. Reporting in the journal AIDS, Italian researchers followed 329 HIVers, all of whom had been on an effective antiretroviral regimen for at least six months. Treatment was interrupted for half of the study participants and restarted only when CD4-cell counts dropped below 350. Over 4.5 years of follow-up, the researchers found that the participants who had taken treatment breaks did not have a greater risk of developing an AIDS-defining event or death than those who continued anti-HIV medications. The development of drug resistance was actually higher in the continuous-treatment arm of the study, according to the analysis. 'The two strategies (continuous treatment versus CD4-guided treatment interruptions) may be considered clinically equivalent,' the researchers concluded. 'CD4-cell-guided scheduled treatment interruptions seem a possible alternative for chronically infected individuals responding to highly active antiretroviral therapy' as long as CD4-cell counts remain above the 350-cell threshold.