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20 July 2006
HIV Treatment Holidays A Bad Idea, Says New Study
by George Atkinson

A meta-study that analyzed existing research into AIDS drug treatment interruptions has confirmed that such "holidays" are a bad idea for HIV patients with uncontrolled cases of the disease. Interrupted treatment regimes have been a hot topic in the HIV community over the past few years, but the overwhelming majority of evidence suggests "greater harm than good" from such interruptions, says researcher Nitika Pant Pai, at the University of California at Berkeley. She added that "there is no evidence, as of now, to support [the use of treatment interruptions] outside of controlled clinical trial settings."

Benefiting from an interruption in drug treatment may seem counterintuitive, but some argue that treatment vacations can improve quality of life by reducing side effects from the medication and making it easier for patients to stick with the drugs once they return to taking them. This isn't hard to understand given the punishing regimes demanded by the first generation of AIDS treatments, often consisting of dozens of different pills that caused a variety of side effects.

In recent years, however, treatment regimes have become more streamlined and easier to tolerate, discounting this theory somewhat.

Some in the medical community wonder if interruptions might actually help patients by halting the development of drug resistance. The idea is to "wash out the resistant strain," said Calvin Cohen, an AIDS specialist with Community Research Initiative of New England. But the new review, appearing in The Cochrane Library, found no evidence that treatment interruptions were helpful. In fact, some of the studies suggested that they may make HIV infection worse by allowing the immune system to deteriorate and the disease to progress.

The researchers say that the "vast majority" of evidence suggests that treatment interruptions are also a bad idea in patients whose HIV is suppressed by drugs. In other words, those who beat back the disease with the help of drugs shouldn't take a break from them. The researchers are now planning a future review that will look at the wisdom of treatment interruptions among newly infected HIV patients.

Based on material from the Cochrane Library




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