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Date Posted: 19:04:36 07/24/02 Wed
Author: moonotter
Subject: Structured Treatment Interruption Seen to Benefit Patients With Highly Resistant HIV

Structured Treatment Interruption Seen to Benefit Patients With Highly Resistant HIV


Reuters Health Information 2002. © 2002 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.


BARCELONA, Spain (Reuters Health) Jul 10 - Patients with advanced HIV infection that has become resistant to all available antiretroviral drug classes might benefit from structured treatment interruption, a leading French researcher said on Wednesday.
Dr. Christine Katlama, of the Hôpital Pitie-Salpetriere in Paris, told Reuters Health at the 14th International AIDS Conference that taking these patients off antiretroviral therapy for a period of 8 weeks resulted in a reduction in viral load when treatment was resumed.

In an open-label study, the French team studied 68 patients who had exhausted all currently available anti-HIV therapies. Eligible patients had a viral load of at least 50,000 copies/mL and CD4 counts below 200/ L.

Half the study group was immediately given "GIGAHAART" (maximal highly active anti-retroviral therapy), including three or four nucleoside reverse transcriptase inhibitors, 500 mg BID hydroxyurea, one non-nucleoside reverse transcriptase inhibitor and three protease inhibitors. The other 34 patients were given an 8-week break before starting the same salvage therapy.

Fifty-three percent of patients in the deferred treatment group experienced a loss of at least one of 29 resistant genotypes examined, Dr. Katlama reported.

Interrupting the treatment seemed to have no adverse effects in these already seriously ill patients, she added.

Viral load in patients randomized to continuous treatment remained constant for 24 weeks after the study began. In contrast, viral load among the structured treatment interruption group dropped by 1 log10 after 24 weeks of resumed drug therapy.

"I was very surprised to see this. I think anyone would have been surprised," Dr. Katlama said. "This study is proof of principle that this approach can benefit those patients who no longer have any treatment options."



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