Studies show progress in 'stop and start' AIDS treatment

Research presented at 13th International AIDS Conference

July 11, 2000
Web posted at: 1:27 p.m. EDT (1727 GMT)

From Christy Feig
CNN Senior Producer

DURBAN, South Africa (CNN) -- A new and easier strategy for taking powerful AIDS drugs was presented at the International AIDS conference Tuesday -- a method that could save millions of dollars for developing countries if it proves effective.

The conference was told that researchers are having patients take a so-called "drug holiday," that is, a break from their normal drug regimen. The method is known as "structured intermittent therapy."

AIDS CONFERENCE
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	RESOURCES
Find out more about the events planned at the 13th International AIDS Conference in Durban, South Africa
	TRANSCRIPT
Read a transcript of CNN's chat with Dr. Ashraf Grimwood, chairman of the National AIDS Convention of South Africa
	MESSAGE BOARD
What public health measures are needed to prevent the spread of the HIV epidemic?

There are 15 drugs approved to treat HIV, the virus that causes AIDS. Doctors use as many as three or four of these drugs in combination, often referred to as a drug cocktail.

But these cocktails can cause debilitating side effects including fever, muscle pain and weakness. They are also quite expensive. Those difficulties have led researchers to search for ways to make the regimen easier to handle.

Dr. Anthony Fauci of the National Institutes of Health reported on the progress of two such clinical trials. One keeps patients on medicine for two months, then off for a month. The other does one week on and one week off.

"The ultimate expense for any given country naturally would be considerably less than if you had to have a regimen in which you gave the drug every day," Fauci said.

Fauci estimates it will take another two years of research to know whether the stop and start method will work. In the meantime, all researchers emphasize that AIDS patients should not try this on their own.

Most other trials in this area are using a similar approach in stopping and starting treatments, but the length of time patients are off the drugs in those studies depends on their "viral load," the level of virus in their blood. To keep a close eye on those levels, the patients must make frequent trips to the doctor for blood tests, which are costly and not always convenient.

The methods Fauci described may never let patients stop drugs, a goal of many other AIDS researchers working on the strategic treatment interruptions. It may not be possible for the immune system to control the virus, he believes.

Fauci said his goal is to retrain the immune system to contain the virus permanently, to induce it to get enough immunity to be free of drugs and free of the rebounding virus. Less time on the drugs, he hopes, ultimately will mean better adherence to the drug regimen, lower toxicity, and lower costs to the patient.

Fauci said it is the lower cost that would have the most significant impact on developing countries.

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