Structured intermittent therapy with seven-day cycles of HAART for chronic HIV infection: a pilot study in São Paulo, Brazil.
In the last 6 years, an impressive impact of the highly active antiretroviral therapy (HAART) on survival and morbidity in HIV-1-infected individuals has been attained. However, their prolonged use may induce metabolic adverse effects such as lipodistrophy, hypertension, diabetes mellitus, osteopenia and hyperlipidemia. Recently, new strategies such as short-cycle structured intermittent therapy (SIT; 7 days without therapy followed by 7 days with HAART) have been suggested. We tested this strategy in seven (four women and three men; mean of age 39 of years) HIV-positive individuals, all of whom had CD4+ T cell counts greater than 500 cells/mm3 and undetectable plasma viral load for at least 2 years. Our results indicated no opportunistic diseases or CD4 cell count decrease over a mean follow-up of 26 months. No plasma viral replication was detected in five of seven cases. There was a decrease in triglyceride levels to normal range (not statistically significant), but no modification of cholesterol levels. Thus, we recommend a larger clinical trial to determine if SIT is cost effective in developing countries.
Casseb
Jorge
J
Laboratory of Allergy and Clinical and Experimental Immunology, Institute of Infectious Diseases "Emilio Ribas," São Paulo, Brazil. j31@hotmail.com
Da Silva Duarte
Alberto José
AJ
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D001938:Brazil; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014505:Urban Population; D019562:Viral Load