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Stop-and-Start HIV Treatment Strategy Gains Ground

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Experts differ on how important treatment interruptions are likely to be in real life. John Moore, PhD, tells WebMD that along with the development of more drugs, approaches like treatment interruptions must also be developed as part of HIV therapy. "[Treatment interruptions must] be validated, but it seems plausible, ... and I think it will be adopted regularly in years to come." Moore is a professor of microbiology and immunology at Weill Medicine College of Cornell University and a researcher at the Aaron Diamond AIDS Research Center in New York.

Treatment interruptions are "more a hope than a certainty," Mark Feinberg, MD, PhD, tells WebMD. "Preliminary data suggests that [treatment interruptions are] not going to be all that effective by itself." Feinberg is associate director of the Emory/Atlanta Center for AIDS Research and an associate professor of medicine and microbiology at Emory University.

Human studies show that treatment interruptions work for patients treated very soon after HIV infection. Lisziewicz thinks this window of opportunity can last for up to nine months. Most patients are in this category -- and that is where the idea of treatment vaccines come in.

Monkeys that were able to fight off the AIDS virus after treatment interruptions developed high levels of a kind of immune cell that recognizes and kills other cells that have become infected with HIV. The Lori/Lisziewicz team has come up with a viruslike vaccine that they hope will be able to stimulate these cells even in people with HIV-damaged immune systems, and early studies are under way. Other research teams are using different approaches to attempt the same feat.

Meanwhile, when it comes to treatment interruptions, all experts contacted by WebMD urge patients not to 'try this at home.'

"We are most concerned that patients will read this report and say, 'I have only to take three weeks on and three weeks off' ... but we do not know whether this is a recipe patients can take," Lisziewicz says. "There is still danger in [treatment interruptions] because you are playing with a very dangerous virus." She says it is very important to wait for the results of more research in large human studies.

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