Long-term interruption of HIV treatment may be safe in certain patients

Interrupting anti-HIV treatment for an extended period and then re-initiating therapy might be safe in some patients, according to a study by Northwestern University infectious disease experts.

Chad Achenbach, M.D., and co-investigators from The Feinberg School of Medicine presented data from their research today at the XIV International AIDS Conference.

In an observational study, 25 HIV-infected patients with viral suppression for at least six months while receiving highly active antiretroviral therapy (HAART) interrupted treatment for an average of nine months.

None of the patients had HIV-related infections or illnesses during the interruption. All of the patients had increases in virus levels and drops in infection-fighting CD4 cells. Patients with lower virus levels prior to treatment and stronger immune systems responded more favorably during the interruption.

When HAART was resumed in 11 of the patients, they experienced maximal viral suppression and robust increases in CD4 cell counts.

Previous studies have examined whether treatment interruption could be used as a strategy for boosting immune response to HIV or reducing resistance to the medications. The current study focused on the effects of stopping HAART for longer periods to minimize complications of the therapy.

“We were surprised that so many patients were able to remain off their therapy for so long a period,” Achenbach said.

“Extended treatment interruption appears safe and, after further study, may be an important HIV treatment strategy for the reduction of long-term toxicity, medication burden and expense,” he said.

Auchenbach cautioned that not all patients should stop therapy, and that if patients do interrupt therapy, they should consult their physician.

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Achenbach’s co-researchers were Michele Till, M.D., assistant professor of medicine; Sophia Terp; Maria Deloria Knoll, M.D., research assistant professor of preventive medicine; Laura Colangelo; Kiang Liu, professor of preventive medicine; Frank Palella, M.D., assistant professor of medicine; Aleks Kalnins; and Robert L. Murphy, M.D., professor of medicine and director of HIV/AIDS clinical research at Northwestern University.

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