Treatment interruption strategies: how great are the risks?

Current Opinion in Infectious Diseases
Nicholas I Paton

Abstract

This review brings together the results of recent definitive trials of treatment interruption strategies in order to evaluate the risks and to examine whether there is evidence to support this approach in clinical practice. Recent studies confirm that there is no clear benefit of treatment interruption in the settings of virological failure or acute infection. The most important recent data relate to the use of structured treatment interruption in the setting of chronic HIV disease. The SMART and Trivacan trials found that a CD4 lymphocyte count guided interruption strategy was clearly inferior to continuous therapy, but Staccato (using a higher threshold for treatment re-initiation) did not. The largest fixed-schedule treatment interruption trial also reported inferior clinical outcomes with interruption, although the evidence of harm was less clear in other smaller studies. A broad spectrum of clinical effects of treatment interruption was highlighted by this research. Overall, recent studies indicate that treatment interruption is associated with a variable degree of net harm. Continuous treatment should remain the strongly preferred approach, although, if it is carefully managed, there may be some clinical situations in whi...Continue Reading

References

Jan 5, 2006·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Heather J RibaudoUNKNOWN Adult AIDS Clinical Trials Group Study
Aug 10, 2006·The Journal of Infectious Diseases·Jeffrey M JacobsonUNKNOWN National Institute of Allergy and Infectious Diseases-AIDS Clinical Trials Group 5068 Protocol Team
Aug 15, 2006·JAMA : the Journal of the American Medical Association·Scott M HammerUNKNOWN International AIDS Society-USA panel
Aug 31, 2006·The Journal of Infectious Diseases·Hendrik StreeckMarcus Altfeld
Sep 5, 2006·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Jody LawrenceJohn D Baxter
Dec 1, 2006·The New England Journal of Medicine·UNKNOWN Strategies for Management of Antiretroviral Therapy (SMART) Study GroupC Rappoport
Feb 16, 2007·AIDS·Bruno MarchouUNKNOWN ANRS 106 Study team
Aug 11, 2007·AIDS·Stephen TaylorDavid Back
Aug 28, 2007·AIDS·Michael J SilverbergDonald I Abrams

❮ Previous
Next ❯

Citations

May 12, 2010·AIDS Research and Human Retroviruses·Milena NasiAndrea Cossarizza
Aug 6, 2013·Human Vaccines & Immunotherapeutics·Salma NowroozalizadehMarianne Jansson
Nov 13, 2015·Journal of the International AIDS Society·Gina M Graziani, Jonathan B Angel
Jan 13, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Brenna L Anderson, Susan Cu-Uvin
Oct 5, 2010·The American Journal of Tropical Medicine and Hygiene·José G B DerraikPhilip Weinstein

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.