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[The current status of structured treatment interruption]
Hirotomo Nakata1, Hiroaki Mitsuya
1Department of Immunophysiology and Internal Medicine II, Department of Clinical Immunology and Infectious Diseases, Kumamoto University School of Medicine.
There is considerable interest in structured treatment interruption(STI), which has been stimulated by certain evidence that treatment interruption may boost the infected individual's immune response to HIV-1. There are several distinct settings where STI may be instituted: (i) STI for those with acute HIV-1 infection, (ii) STI for those with chronic infection, and (iii) STI before switching drugs. A number of STI protocols have been evaluated and certain promising results have been reported in certain groups of HIV-1-infected individuals while viral rebound as the consequence of interruption has been seen in other patients and drug failure to re-suppress HIV-1 upon re-starting therapy, STI-associated CD4+ cell decline and viral drug resistance emergence have been serious concern. Currently, STI cannot be recommended in clinical settings. Randomized, controlled trials to determine the applicability of STI for therapy of HIV-1 infection are required.
There is considerable interest in structured treatment interruption(STI), which has been stimulated by certain evidence that treatment interruption may boost the infected individual's immune response to HIV-1. There are several distinct settings where STI may be instituted: (i) STI for those with acute HIV-1 infection, (ii) STI for those with chronic infection, and (iii) STI before switching drugs. A number of STI protocols have been evaluated and certain promising results have been reported in certain groups of HIV-1-infected individuals while viral rebound as the consequence of interruption has been seen in other patients and drug failure to re-suppress HIV-1 upon re-starting therapy, STI-associated CD4+ cell decline and viral drug resistance emergence have been serious concern. Currently, STI cannot be recommended in clinical settings. Randomized, controlled trials to determine the applicability of STI for therapy of HIV-1 infection are required.