Reuters 10 July 2001

Chicago -- The reappearance of worrisome levels of the AIDS virus in infected patients' bloodstreams does not mean the drug therapy they are using has failed, researchers said on Tuesday.

The importance of the finding that HIV levels can rise modestly for a time and then subside again and are not a sign of a therapy regimen's failure could spare patients who rush to switch to different drugs and then run out of options.

Doctors writing in this week's issue of the Journal of the American Medical Association studied 254 AIDS-infected patients over a 4-1/2-year span and discovered those with intermittent increases in blood levels of the virus actually had a lower rate of treatment failure than those who did not have occasional increases in HIV levels.

"Clinical management options are increased by this knowledge. A higher HIV RNA level that could trigger a therapy change may preserve the number of drugs available for future therapeutic regimens," wrote study author Diane Havlir of the University of California, San Diego.

An editorial accompanying the study in the journal said the longer-term effects of viral recurrences need to be looked at, but that it may not be necessary to completely suppress the virus in infected patients.

"It must now be accepted that current therapeutic regimens may not be able to completely suppress viral replication, even when used under optimal conditions," wrote Steven Deeks of the University of California, San Francisco.

"Fortunately, complete viral suppression does not appear to be a prerequisite for durable virologic and presumably, clinical benefit," he wrote.