HIV RNA in plasma rebounds within days during structured treatment interruptions
- 1 January 2003
- journal article
- clinical trial
- Published by Wolters Kluwer Health in AIDS
- Vol. 17 (2), 195-199
- https://doi.org/10.1097/00002030-200301240-00009
Abstract
To evaluate time to viral rebound in patients undergoing repeated structured treatment interruptions (STI). Fourteen chronically HIV-infected patients enrolled in the Swiss–Spanish Intermittent Treatment Trial (SSITT) underwent frequent blood sampling. Patients underwent four cycles of 2-week STI, followed by 8-week retreatment with the identical antiretroviral treatment (HAART) used before STI. At the fifth cycle, treatment was stopped for a longer period. Before each new STI, plasma viral load (VL) had to reach Results: During the first cycle, plasma HIV RNA increased to > 50 copies/ml (range, 67–88) in five patients at day 4, in eight patients (> 100 copies/ml) at day 8 and in 12 patients (> 100 copies/ml) at day 14. Cumulative analysis of the frequency of detectable HIV RNA at days 4, 8 and 14 compared with day 0 for all five cycles revealed nine patients with VL > 50 copies/ml [13 of 54 samples tested (24.1%); P = 0.14] at day 4, 11 patients [33 of 58 samples tested (56.9%); P Conclusions: Significant viral replication can be induced during 1 week STI, and this may increase the risk of the emergence of drug resistance during long-term cycling. Therefore, short-term cycling strategies such as 1-week-on, 1-week-off treatment, although conceptually intriguing, should still be regarded as investigational and should be restricted to rigorously controlled clinical trials ideally involving patients who have never failed treatment before.Keywords
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