Structured Treatment Interruptions – Hope or Hype

There is great interest in the use of structuredtreatment interruptions (STI) for the managementof HIV disease, in large part due to the concernsof drug related toxicity associated with continuous,long-term therapy. STIs are being evaluatedin several different settings. When antiretroviraltherapy is initiated with acute HIV or SIV infection,subsequent treatment interruptions stimulateimmune responses, enhancing control of viralreplication (Rosenberg et al., Nature 2000;407:523-6). In theory, HIV could then be managedwith less intensive drug regimens because ofaugmented host responses. At the opposite endof the spectrum -patients with chronic infectionand multidrug resistant HIV-, a period of treatmentinterruption permits re-population of drugsensitive virus that may be more responsive tonew therapy (Deeks, et al., N Engl J Med 2001;344:472-80).