Short cycles of antiretroviral drugs provide intermittent yet effective therapy: a pilot study in 48 patients with chronic HIV infection

The present study evaluated the efficacy of intermittent antiviral treatment administered to HIV-infected patients under stepwise reductions in weekly medication. Forty-eight patients were invited to reduce their antiviral medication to 5 consecutive days per week; after control over HIV activity was ascertained, antiviral drugs were cut to 4 consecutive days per week. Of the 48, 39 then reduced medicines further to 3 d, and 12 of those eventually undertook a 2 d/wk schedule. Clinical and immunological status and plasma HIV load were repeatedly monitored. HIV was unremittingly maintained below detection levels in all patients under either 5- or 4-d/wk treatment regimens, for a mean 56 ± 40 wk/patient (5-d regimen) and 84 ± 46 wk/patient (4-d regimen). Of the 39 patients under 3-d regimens, 35 maintained optimal control over HIV activity for a mean 50 ± 32 wk, as did 10 of the 12 under 2-d regimens, for 24 ± 10.5 wk. Summing up treatment ≤ 5 d/wk, plasma HIV remained below detection levels for a cumulative...