Intermittent therapy for the treatment of chronic HIV infection [editorial]

HAART has changed HIV infection from a life-threatening into a chronic condition but the perspective of never ending HAART once it is started is daunting to many patients. As a cure for HIV infection is currently not in sight many patients who are looking to their physicians for advice on whether to stop HAART. New drugs and combinations with better safety and tolerability profiles have become available but there will still be patients who experience toxicity; therefore being able to take a rest from HAART may be beneficial. Worldwide the cost of treating millions with HIV burdens fragile economies; intermittent treatment promises relief. Many scheduled treatment interruption (STI) studies have shown between 40 and 60% drug savings with STI. For example in Thailand using the least expensive generic fixed dose combination of stavudine/lamivudine/nevirapine which is US$27 per month the yearly cost of treating 500 000 HIV-positive individuals would decrease from US$162 million to US$81 million if there is a 50% drug saving. (excerpt)