Living + Magazine Issue 1 - Positive Living BC

TREATMENT INFORMATION
PROGRAM MANDATE &
DISCLAIMER
IIn accordance with our mandate to
provide support activities and
facilities for members for the
purpose of self-help and self-care,
the BCPWA Society operates a
Treatment Information Program to
make available to members up-todate
research and information on
treatments, therapies, tests, clinical
trials, and medical models associated
with AIDS and HIV-related
conditions. The intent of this project
is to make available to members
information they can access as they
choose to become knowledgeable
partners with their physicians and
medical care team in making
decisions to promote their health.
The Treatment Information
Program endeavors to provide all
research and information to
members without judgement or
prejudice. The project does not
recommend, advocate, or endorse
the use of any particular treatment
or therapy provided as information.
The Board, staff, and volunteers of
the BCPWA Society do not accept
the risk of, nor the responsibility for,
damages, costs, or consequences of
any kind which may arise or result
from the use of information
disseminated through this project.
Persons using the information
provided through this project do so
by their own decisions and hold the
Society’s Board, staff, and volunteers
harmless. Accepting information
from this project is deemed to
be accepting the terms of this
disclaimer.
Antiretroviral drug holidays –
a potentially risky practice
by JULIO MONTANER B.C. CENTRE FOR EXCELLENCE IN HIV/AIDS
Data was presented at the last
Retrovirus Conference in
Chicago earlier this year illustrating
the experience of a
limited number of patients
who had discontinued
therapy at a couple of different
time points. Such patients
saw their plasma viral load stabilized
at a lower level each
time and it was speculated
that intermittent courses of therapy may
have played a role in bringing the viral
load down in such patients.
The same researchers presented the
data gathered in a limited number of
monkeys infected with the Simian
Immunodeficiency Virus
which appeared to reproduce
this phenomenon. This represents
an interesting observation
which merits further prospective
investigation. At this time a
strong word of caution should go out
for those contemplating experimenting
with this kind of approach. Although interruption
of therapy has been implemented
in the past when the clinical circumstances
so mandated, this is not
something that should be taken lightly.
Recent work at the Centre suggests
that drug interruptions may be hazardous.
We have now studied half a dozen
individuals who voluntarily came off
treatment after prolonged periods of
Julio Montaner
full suppression of viral replication
as best that we can measure
with current laboratory assays.
Despite having been adequately
suppressed for periods
often in excess of a couple of
years, such patients demonstrated
a detectable plasma viral
load within only days after
the discontinuation of therapy.
In fact, all of them had detectable
viral load within a month of stopping
treatment. Of some concern the
rebound in virus was found to have mutations
characteristically associated with
resistance to at least one of the drugs in
A strong word of caution
should go out for those
contemplating experimenting
with this kind of approach
the cocktail in a number of patients. The
ultimate significance or the reasons for
these are unclear but once again it highlights
the potential problems that may
be associated with intermittent use of
therapy.
Until further data is available we
should encourage full and strict adherence
to triple drug therapy regimens as
this has been clearly shown to be the key
to long-term suppression of viral replication.
information
treatment
JULY/AUGUST 1999 • LIVING + 15