Reuters 3 Dec. 2001

Washington -- Letting patients with HIV take their medicines on a one-week-on, one-week-off schedule might save some money and might help reduce side-effects, researchers said on Monday.

They said such a regime -- carefully monitored by an expert doctor -- worked to control the AIDS virus well.

Patients could cut the costs of medication in half and might have fewer side-effects because of the regular drug holidays, a team at the National Institute of Allergy and Infectious Diseases (NIAID) said.

The approach, called "structured intermittent therapy," has been studied for a few years and NIAID experts had said it offered promise.

Patients with HIV can live for years and even decades in good health thanks to a cocktail of drugs known as highly active antiretroviral therapy (HAART). But the drugs are extremely expensive and the regimes require patients to take dozens of pills a day.

Side-effects can be severe and range from diarrhea to changes in metabolism.

In the latest study, the NIAID's Dr Mark Dybul and colleagues gave the week-on, week-off treatment to 10 patients.

"Because it halves the total time during which patients receive anti-HIV medications, structured intermittent therapy could significantly reduce the costs and side effects of anti-HIV drugs, important issues in both resource-rich and poor countries," Dybul said in a statement.

"It is important to stress, however, that the results of randomized, controlled clinical trials -- currently under way -- are needed to prove the benefits of this experimental approach before it can be recommended to patients outside the setting of a controlled clinical trial. Don't try this at home!"

Writing in the Proceedings of the National Academy of Sciences, the researchers said their 10 patients fared well on the therapy. Levels of the virus stayed low and their immune systems looked healthy -- two important measures in HIV infection.

The patients also had reduced cholesterol levels. High cholesterol is often a side-effect of HAART.

NIAID chief Dr. Anthony Fauci said the approach might be especially useful in poorer countries where HIV drugs are scarce.

"Ultimately, structured intermittent therapy might be adapted for use in developing nations, where more than 95 percent of the world's HIV-infected people live, but where very few have access to HAART because of the cost of antiretroviral agents," he said in a statement.