Structured treatment interruptions

May 2008      View PDF      En español

The most notable research to date

The most notable research to date on STIs comes from the SMART study. It compared two strategies in nearly 6,000 people worldwide: continuous treatment vs. regularly interrupted treatment guided by CD4 counts. The researchers had expected that by keeping people off medicines for periods of time, there would be lower rates of long-term problems like heart disease, which have been linked to HIV drugs.

The opposite was true. SMART was stopped early when the data showed that people who interrupted treatment had higher rates of illness and death. This finding was quite unexpected. Some believe these results are so bad that STIs have been proven to be risky and should be avoided in most cases. Others feel that SMART raises some concerns, but reasons still remain to study other kinds of STIs.

SMART isn’t the only study to highlight the dangers of STIs. Others — like PART, DART and TRIVICAN — have shown similar results. However, a recent Swiss study found that STIs may be safe for people who started HIV treatment with higher CD4 counts.